The contaminated high-energy open fracture: A protocol to prevent and treat inflammatory mediator storm-induced soft-tissue compartment syndrome (IMSICS)

Lawrence X. Webb, Barnaby Dedmond, Dan Schlatterer, David Laverty

Research output: Contribution to journalArticle

16 Scopus citations

Abstract

The treatment modalities currently used in surgical débridement leave the traumatic wound with viable but tenuous tissue and a variable level of microcontaminants potentially laden with bacteria. In high-energy contaminated wounds, retention of these contaminants within the tenuous tissue of the so-called zone of stasis can result in further tissue necrosis and the development of infection. A novel protocol for managing the high-energy contaminated open fracture involves two new techniques. First, Bernoulli's principle is used to facilitate a systematic excision of contaminants, as well as the wound surface to which they are adsorbed, by means of a high-velocity fluid stream. Second, topical negative pressure is established as a means to resuscitate the remaining edema-laden wound tissue to help avoid embarrassment to microcirculatory blood flow.

Original languageEnglish (US)
Pages (from-to)S82-S86
JournalJournal of the American Academy of Orthopaedic Surgeons
Volume14
Issue number10
DOIs
StatePublished - Sep 2006

ASJC Scopus subject areas

  • Surgery
  • Orthopedics and Sports Medicine

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