Wound management 1 – Emergency management of open fractures
An open fracture is any fractured bone that is exposed to environmental contamination due to disruption of soft tissues surrounding the bone. By extension, if there is a skin wound in a limb or body segment that has a fracture...
Any fracture with a skin wound anywhere in that body segment should be considered an open fracture and to be at increased risk for later infection.
Open fracture wounds should be treated on an emergency basis, but immediate rigid stabilization of the fracture itself is not an emergency.
Every patient with vehicular trauma should receive a minimum of chest and abdominal radiographs, CBC, serum chemistry, ECG, pulse oximetry and blood pressure measurements to assess potential co-morbidities.
Initial sterile wound dressings should be applied while the patient is assessed and stabilized to protect against infections from nosocomial organisms, and systemic broad-spectrum antimicrobials should be given as soon as possible.
External skeletal fixators allow open wound access while providing rigid fixation, preserving bone blood supply and minimizing soft tissue disruption.
An open fracture is any fractured bone that is exposed to environmental contamination due to disruption of soft tissues surrounding the bone. By extension, if there is a skin wound in a limb or body segment that has a fracture, this should be considered as an open fracture, regardless of whether or not the fracture is assumed to communicate with the wound. One study reported that open fractures occurred in 16.7% of all traumatic fractures in dogs and cats, and vehicular trauma, younger age, larger body weight, and fracture comminution were associated with a greater likelihood of open fracture 1.