1. IV antibiotics immediately
2. Tetanus update

Treatment Guided by Gustilo-Anderson Criteria

Gustilo-Anderson Criteria

1. ED → Radiographs

1. IV antibiotics immediate
2. Tetanus update
3. Gentle irrigation (remove gross debris) + Sterile dressing
4. Reduce and splint BEFORE X-ray → Emergency Closed Reduction Protocol
5. 2 Plane XR (Bone and Joint)

2. Surgical Irrigation and Debridement (< 6 hr)

• I + D
  • Thorough debridement of all devitalized tissue from superficial to deep
  • Irrigation (3L per open grade)
• Stabilization
  • ex-fix vs. OPIF - Open Reduction Internal Fixation
• Closure
  • Primary closure
  • Split-thickness skin graft
  • +/- FF, vascular bypass
• Post-operative Abx x 24 hours (once wound is closed)