Open fracture tibia: How I debride and stabilise

An open fracture is a serious injury and is associated with many complications and poor outcomes. Saving a patient's life precedes saving a limb. Once a patient's life is not in threat, the early aim is to prevent infection. This is done by early systematic debridement and stabilisation. Debridement starts with wound extension following the fasciotomy line to avoid damaging the skin vascular perforators. Once wound extension is adequate, it should be easy to visualise the bone and soft tissue damage caused by the injury. Removal of all devitalised tissue and the necrotic bone edge by the saw is mandatory to minimise the risk of infection. Stabilization of fracture should be done by a spanning external fixator bypassing the zone of injury. A temporary negative pressure dressing is an excellent temporary method of wound management before wound closure. The risk of wound complication is much less when wound closure is done within a week of injur