Delays in open fracture management: where do they occur?

• Published in: Injury Vol. 35; no. 11; pp. 1107 - 1109
• Main Authors: Ashford, Robert U., Frasquet-Garcia, Antonio, Patel, Kalpit K., Campbell, Peter
• Format: Journal Article
• Language: English
• Published: Oxford Elsevier Ltd 01.11.2004; Elsevier
• Subjects: Audit; Biological and medical sciences; Debridement - standards; Delay; Diseases of the osteoarticular system; England; Female; Fracture Fixation - standards; Fractures, Open - diagnostic imaging; Fractures, Open - surgery; Humans; Injuries of the limb. Injuries of the spine; Male; Medical Audit; Medical sciences; Multiple Trauma - surgery; Open fractures; Radiography; Time Factors; Traumas. Diseases due to physical agents; Audit; Open fractures; Delay; Human; Gold; Speed; Skin disease; Injury; Diseases of the osteoarticular system; Effort; Trauma; Standards; Symptomatology; Clinical management; Treatment; Open fracture; Operating room; Surgery; Anesthesia; Bone; Inaugural sign
• ISSN: 0020-1383; 1879-0267
• DOI: 10.1016/j.injury.2004.01.014

We audited the delays in the management of 29 patients presenting to our department with 30 open fractures over a 1-year-period to ascertain where the most lengthy delays were occurring. Gold standard treatment is the surgical debridement and stabilisation of the fracture within 6 h of injury. In our series only 14 patients achieved this standard. The lengthiest delays were in getting a patient to the operating theatre following orthopaedic assessment. We have introduced an “open fracture proforma” to highlight the time-critical nature of the injury in an effort to speed-up the process.