section: 0/9 page: 1/6 next

Treatment - initial surgery for fracture wound infection

Infected wound after extensive débridement

Introduction

If an infection is strongly suspected, the surgeon must proceed urgently to exploration of the wound, obtaining tissue for culture, and removing all non-viable tissue and exudates.
Such débridement (see below) involves the surgical excision of all necrotic and/or infected tissue from the wound.

Débridement must include:

  • Wide exposure of the whole pathological zone
  • Removal of all exudate (hematoma and pus)
  • Removal of the abscess membrane
  • Removal of sinus tracts
  • Removal of granulation tissue
  • Removal of unhealthy wound margins
  • Removal of all dead bone
  • Removal of loosened hardware

Look carefully for dead bone and any remaining foreign material. Preserve nerves, identifiable blood vessels and viable tendons.