Management Sequence for Open Fractures
Jan 15, 2022
Source: Cainiu Health
Dr. Lin Yunfei
Introduction
1. Wound Cleansing: Open fractures are accompanied by obvious skin wounds. Irrigate the wound with normal saline to help prevent contamination, followed by local disinfection with iodophor.
2. Hemostasis: For open fractures with minimal bleeding, apply local pressure dressing to achieve hemostasis.
3. Fracture Reduction: Perform external fixation using plaster casts or splints.
Open fractures are typically caused by high-energy trauma. But what is the specific sequence for managing open fractures? The following section addresses this question.
Management Sequence for Open Fractures
1. Wound Debridement
Open fractures involve obvious skin wounds. Irrigation with normal saline helps prevent wound contamination, followed by local disinfection using iodophor.
2. Hemostasis
Significant bleeding commonly occurs with open fractures. For minor bleeding, local pressure dressings may suffice. For substantial hemorrhage, a tourniquet may be applied. If major vessels are injured, hemostatic clamps can be used for vessel ligation and hemostasis.
3. Fracture Reduction and Immobilization
After wound debridement and hemostasis, fracture reduction should be performed, followed by external immobilization using plaster casts or splints to facilitate rapid bone healing.
Additional Information: Key Considerations in Open Fracture Management
1. Avoid speaking or coughing directly over the wound during dressing changes.
2. Change dressings immediately if the wound or gauze becomes contaminated, wet, or shows increased discharge.
3. Protect limbs stabilized with external fixators from impact to prevent re-fracture.
4. During bathing, use showering or sponge bathing only; seal the wound with a plastic bag and avoid direct water contact with the wound site.
5. Replace dressings promptly if gauze or the wound becomes accidentally wet.
The above outlines the standard management sequence for open fractures. We hope this information is helpful to you.
