CARE of hand injuries. VI. Open fractures.
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The orthopedist's goals are to prevent wound infection, expedite fracture healing, and restore optimal function. The importance of the soft tissue envelope to fracture healing is well recognized. In spite of continual research concerning wound repair, we remain at a loss to define precisely what starts the wound healing process and what ultimately stops it. In this article, we consider the basic science of wound repair, the effects of the patient's nutrition and volume status, soft tissue wound dressing options, soft tissue transfers, and specific recommendations.
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With regard to a case report and the review of literature the authors point out that this uncommon but severe infection due to an aero-anaerobia bacteria, existing preferentially in stagnant or running water. This seriousness leads to the use of appropriate antibiotics instead of those usually prescribed in compound fractures, and most of the time, to the use of irrigation-stucking drainage of the wounds.
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