TY - JOUR
T1 - The contaminated high-energy open fracture
T2 - A protocol to prevent and treat inflammatory mediator storm-induced soft-tissue compartment syndrome (IMSICS)
AU - Webb, Lawrence X.
AU - Dedmond, Barnaby
AU - Schlatterer, Dan
AU - Laverty, David
PY - 2006/9
Y1 - 2006/9
N2 - 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.
AB - 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.
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U2 - 10.5435/00124635-200600001-00019
DO - 10.5435/00124635-200600001-00019
M3 - Article
C2 - 17003216
AN - SCOPUS:34547946787
VL - 14
SP - S82-S86
JO - The Journal of the American Academy of Orthopaedic Surgeons
JF - The Journal of the American Academy of Orthopaedic Surgeons
SN - 1067-151X
IS - 10
ER -