A “second look” and possibly further débridements should be undertaken, until the wound surface is completely viable. Staged surgical clearance is illustrated.
Local débridement of an infected nonunion is characterized by:
a) The nonunion is covered by granulation tissue, stained with methylene blue, previously injected into the sinus.
b) After excision of the granulation tissue, the necrotic bone adjacent to the nonunion contrasts directly with the vital bone.
c) After complete surgical clearance, only vital bleeding bone and soft tissue is seen.