open fractures Flashcards
What is an open fracture
Fracture where there is a direct communication between the fracture and the external environment
Which bones are most commonly involved in open fractures
Fingers and tibial shaft
Describe the gustilo classification
As you go from type 1-3 - the open fracture becomes more severe
What is the management of open fractures
ATLS assessment - ABCDE
Tetanus and antibiotic prophylaxis
Debridement
Cover wound with saline swabs
Surgical emergency surgery for open fractures - usually within 24 hours unless there are specific complications
What is the antibiotic prophylaxis given for open fractures
Cefuroximen
Augmentin
Clindamycin
What are the conditions that indicate emergency within <6 hours surgery (6 hour rule) for open fractures
Polytraumatised patient
Marine or farmyard environment
gross contamination
Neurovascular compromise
Compartment syndrome
What is debridement
removal of dead tissue
What is the criteria to differentiate dead tissue
4 C’s
Colour
Contraction - if muscle
Consistency
Capacity to bleed
What conditions lead to the decision of amputation
Loss of sensation in the limb
irretrievable soft tissue or bone damage
other life threatening injuries