Timing issue in open fractures debridement: a review article

Open fractures constitute a major trauma mostly sustained by young adults during high-energy injuries. Management of long bone open fractures is a very complex issue and is often complicated by nonunion and deep infection being among the most devastating and difficult to cure. It is generally recommended that wound debridement and stabilization of open fractures should be performed as early as possible, preferably within 6–8 h on the basis of historical comment and laboratory data. The rationale for this rule is believed to originate from Freidrich’s historical study of guinea pigs. The literature lacks strong evidence addressing the primary issue of timing and delay on the incidence of deep infection and nonunion in open fractures. In the light of the actual literature regarding this topic, it seems that time to debridement of open fractures is not a prognostic factor of infection as well as nonunion.