Open limb fractures are commonly encountered as part of our daily practice. They are often complex injuries to manage and require a multidisciplinary team due to the musculoskeletal and associated soft-tissue injuries (1-3). The annual incidence of open fractures of long bones is 11.5 per 100,000 persons per year with 40% of them occur in the Lower Limb (LL) (4,5).
Several classification systems have been used to grade the extent of injury and helped define the contemporary approach to the management of open fractures (6-10). The most commonly used system is the Gustilo-Anderson (G-A) classification, which is based on three factors to determine the fracture severity; the size of the open wound, the degree of contamination and the extent of soft tissue injury (6,7). …show more content…
Since then there has been more research and clinical evidence published in this area of practice. Therefore, in 2009 the two professional organizations updated the standards of care for these injuries using an evidence-based approach, in collaboration with the British Infection Society and the Association of Medical Microbiologists to ensure antibiotic prophylaxis is adequate (13,14).
The BOAST4 guidelines are derived from these standards (13,14). They recommend; early identifications of severe open fractures of LL, antibiotics prophylaxis to be administered as soon as possible and within three hours of injury, a multidisciplinary team, including orthopaedic and plastic surgeons with appropriate experience is required for the treatment of these injuries, surgical wound debridement and operative fracture stabilization within 24 hours, and definite soft tissue cover within 72 hours of
Several classification systems have been used to grade the extent of injury and helped define the contemporary approach to the management of open fractures (6-10). The most commonly used system is the Gustilo-Anderson (G-A) classification, which is based on three factors to determine the fracture severity; the size of the open wound, the degree of contamination and the extent of soft tissue injury (6,7). …show more content…
Since then there has been more research and clinical evidence published in this area of practice. Therefore, in 2009 the two professional organizations updated the standards of care for these injuries using an evidence-based approach, in collaboration with the British Infection Society and the Association of Medical Microbiologists to ensure antibiotic prophylaxis is adequate (13,14).
The BOAST4 guidelines are derived from these standards (13,14). They recommend; early identifications of severe open fractures of LL, antibiotics prophylaxis to be administered as soon as possible and within three hours of injury, a multidisciplinary team, including orthopaedic and plastic surgeons with appropriate experience is required for the treatment of these injuries, surgical wound debridement and operative fracture stabilization within 24 hours, and definite soft tissue cover within 72 hours of