Primary Management and Antibiotic Prophylaxis in Open Injuries of the Lower Limb: Current guidelines

Vol 4 | Issue 1 | May – Aug 2018 | page:4-6 | Dheenadhayalan Jayaramaraju, Raja Bhaskara Rajasekaran, Devendra Agraharam, Ramesh Perumal.

doi-10.13107/ti.2018.v04i01.056


Author: Dheenadhayalan Jayaramaraju [1], Raja Bhaskara Rajasekaran [1], Devendra Agraharam [1], Ramesh Perumal [1].

[1] Department of Orthopaedics & Trauma Ganga Medical Centre & Hospitals Pvt. Ltd, 313, Mettupalayam road, Coimbatore, India

Address of Correspondence
Dr. Raja Bhaskara Rajasekaran,
Ganga Hospital, Mettupalayam road,Coimbatore, India
Email: rajalibra299@gmail.com


Abstract

Primary management of open injuries is of utmost importance as it has direct implication on the functional outcome. Strict adherence to the ATLS protocol followed by appropriate splintage of the limb must be done. While antibiotics need to be given within 3 hours since injury, wound lavage and wound cultures have no role. Documentation and adequate counselling regarding the complications also needs to be done while managing every case of open injury.
Keywords: Open injury, antibiotic prophylaxis, wound lavage, limb splintage


References

1. Dabezies EJ and D’Ambrosia RD. Treatment of the multiply injured patient: plans for treatment and problems of major trauma. Instructional course lectures 1984; 33: 242-52.
2. Hoff WS, Reilly PM, Rotondo MF, DiGiacomo JC, and Schwab CW. The importance of the command-physician in trauma resuscitation. The Journal of trauma 1997; 43: 772-7.
3. Initial Management of Open Fractures. (Book Chapter) S. Rajasekaran et al. Rockwood and Green’s Fractures in Adults. Eigth Edition. Vol 1 :353-396.
4. Kreder HJ and Armstrong P. The significance of perioperative cultures in open pediatric lower-extremity fractures. Clinical orthopaedics and related research 1994: 206-12.
5. Lee J. Efficacy of cultures in the management of open fractures. Clinical orthopaedics and related research 1997: 71-5.
6. Gosselin RA, Roberts I, Gillespie WJ. 2004: Antibiotics for preventing infection in open limb fractures. Cochrane Database Syst Rev; Issue 1: Cd003764.
7. BAPRAS Guidelines: Standards for management of open fractures of the lower limb. 2009


How to Cite this article:  Dheenadhayalan J, Rajasekaran R B, Agraharam D, Ramesh Perumal R. Primary Management and Antibiotic Prophylaxis in Open Injuries of the Lower Limb: Current guidelines. Trauma International May -Aug 2018;4(1):4-6.


(Abstract Text HTML)      (Download PDF)