Exam II Lecture 6 Open fracture Mgt Dr. Smith Flashcards
What does the Gustillo and Anderson classification system describe?
Open fractures.
Gustillo and Anderson type 1 classificaton?
Clean puncture wound <1 cm with very little soft tissue damage.
Gustillo and Anderson Type 2 Classification?
Laceration greater than 1 cm in length with moderate contamination but no extensive soft tissue damage.
Moderate communution occuring.
Gustillo and Anderson Type 3A Classification?
Extensive laceration that has adequate soft tissue coverage.
there is severe comminution occuring here.
Gustillo and Anderson type 3B classification?
Massive contamination with extensive soft tissue loss and periosteal stripping.
Gustillo and Anderson Type 3C classification?
Open Fracture >10mm that has an arterial injury present.
What is the cornerstone for open fracture treatment?
Irrigation and debridement.
try to get to that wound within 6 hours!
What is the antibiotic protocol for open fractures?
48-72 hours repeat with signs of infection or take it back to the operating room.
Use Pen G in anything derm related that are clostridium prone.
What is the antibiotic therapy of choice for class 1 open wounds?
Ancef 2gm IV Q 8h within three hours and continued for 24 hours.
what is the antibiotic therapy of choice for class 2 and three open wounds?
Combined therapy of Cefazolin and aminoglycosides within three hours and continued 48-72 hours
What are the three indication for amputation?
Massive uncontrolled sepsis
Necrosis and Gangrene
Primary amputation
A mess score of…. indicated amputation
Greater than 7
