Debridement and wound closure of open fractures: The impact of the time factor on infection rates

Fraturas da diáfise da tíbia

“…In conclusion, we can use the recommendations by Crowley et al (23) , who claim that, to grades I, II and IIIA fractures do not suffer hospital contamination after cleaning and debridement, an early closure of the injury should be performed. The exceptions to this rule are cases of excessive contamination and closure where there is a lot of tension.…”

“…In the review by Crowley et al (23) on time and infection, the authors concluded that the principle of treatment within six hours must be revised, but debridement should be performed as early as possible.…”

Medial Gastrocnemius Flap for Reconstruction of the Extensor Mechanism of the Knee Following High-Energy Trauma. A minimum 5 year follow-up

“…Management of open injuries with aggressive débridement and early coverage is a basic principle of modern treatment, often involving muscle flaps to restore the soft tissue envelope [8]. Reconstruction of the extensor mechanism using the medial gastrocnemius muscle has been previously described for combined tissue loss during revision knee arthroplasty or tumour surgery [5,15,20,26,27], but few prior reports describe its use as a post-traumatic reconstructive option [3,7,16,23].…”

“…Soft tissue coverage with viable muscle delivers nutrients and antibiotics to augment control of bacterial contamination, limiting the risk of further infection [8]. With this constellation of injuries it is important to restore the extensor mechanism while minimizing immobilisation, to reduce potential stiffness and maximise the power of knee extension [25].…”

CORR Insights®: d-amino Acid Inhibits Biofilm but not New Bone Formation in an Ovine Model

“…C omplex musculoskeletal injuries are complicated by infections in as many 30% of traumatized patients [2], depending on the type of injury and the timing of the interventions. Biomaterials often are necessary components to restore function and promote healing in injuries where muscle, nerve, and bone damage present challenges to healing.…”