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2Principles of surgical care for open fractures

Open fractures need prompt diagnosis, appropriate intravenous antibiotics, meticulous injury...

Introduction

Open fractures need

  • prompt diagnosis
  • appropriate intravenous antibiotics
  • meticulous injury zone excision (débridement) *
  • fracture stabilization
  • second look
  • early soft-tissue cover after soft-tissue recovery

* Such surgery is frequently referred to as débridement. This term is open to interpretation and denotes different procedures in different surgical contexts.
Débridement, as used in this discussion, means the surgical exposure of the whole pathological injury zone and the removal of all necrotic, contaminated, and/or damaged tissue, whether bony or soft-tissue.