.What is Emergency Medicine - Which open fractures require prompt attention?
Open fractures require prompt orthopedic attention. Open fractures are evaluated during the secondary survey once any concomitant damage to important organs have been ruled out. Until proven otherwise, any skin break close to a fracture site should be assumed to communicate with the fracture. Apply a sterile dressing to the wound after thorough evaluation, including a neurologic and vascular assessment, and clear it of any significant contamination. Wound probing is not advised in the emergency department (ED) until absolutely necessary to stop bleeding. Direct pressure should always be applied to control hemorrhages. Splinting and axial realignment immobilize the bone, reducing blood loss and preventing additional harm to the soft tissue. Due to the increased risk of secondary contamination and soft tissue damage, avoid wound culturing, thorough irrigation, and repeated examinations of the wound. administer intravenous (IV) antibiotics and tetanus vaccinations. For antibiotic prophylaxis, a first-generation cephalosporin like cefazolin is most frequently used. Consider using piperacillin/tazobactam or adding an aminoglycoside in more severe open fractures, Gustilo-Anderson 3 fractures, and fractures that are severely contaminated.
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