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  • Ceph Vs G. (+) Aminogly Vs G (-) Penicillin/Metro Vs Anaerobes

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    Ryan Michael Villar
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    The Gustilo classification system categorizes open fractures into three types based on the degree of soft tissue damage and contamination. Type I fractures have a wound less than 1 cm with minimal soft tissue injury. Type II fractures have larger wounds with more soft tissue damage. Type III fractures have extensive soft tissue loss and high contamination, with Type IIIC having severe vascular injury. Treatment involves thorough irrigation, antibiotic therapy specific to the contamination level, and stabilization of the bone depending on the fracture type.

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    Gustillo classification of open fx

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    Open Fx

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    The Gustilo classification system categorizes open fractures into three types based on the degree of soft tissue damage and contamination. Type I fractures have a wound less than 1 cm with minimal soft tissue injury. Type II fractures have larger wounds with more soft tissue damage. Type III fractures have extensive soft tissue loss and high contamination, with Type IIIC having severe vascular injury. Treatment involves thorough irrigation, antibiotic therapy specific to the contamination level, and stabilization of the bone depending on the fracture type.

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    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd
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    8 views1 page

    Ceph Vs G. (+) Aminogly Vs G (-) Penicillin/Metro Vs Anaerobes

    Uploaded by

    Ryan Michael Villar
    The Gustilo classification system categorizes open fractures into three types based on the degree of soft tissue damage and contamination. Type I fractures have a wound less than 1 cm with minimal soft tissue injury. Type II fractures have larger wounds with more soft tissue damage. Type III fractures have extensive soft tissue loss and high contamination, with Type IIIC having severe vascular injury. Treatment involves thorough irrigation, antibiotic therapy specific to the contamination level, and stabilization of the bone depending on the fracture type.

    Copyright:

    © All Rights Reserved
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    of 1

    GUSTILO CLASSIFICATION

    Wound
    Level of Contamination
    Soft Tissue Injury

    Open Fracture Type I


    <1cm
    Clean
    Minimal

    Open Fracture Type II


    >1cm, <10cm
    Moderate
    Moderate, Some
    muscle damage

    Bone Injury

    Simple, minimal
    comminution

    Mechanism of Injury
    Other Notes

    In-Out
    No Crushing, simple
    fracture
    Intact vascular status
    Compartment
    syndrome most
    common
    1st Gen
    Cephalosporin
    (Cefazolin)

    Antibiotic of Choice
    Ceph vs G. (+)
    Aminogly vs G (-)
    Penicillin/Metro vs anaerobes

    Reduction of Bacterial
    Contamination
    Stabilization

    Open Fracture Type IIIA


    >10cm
    High
    Severe with crushing

    Open Fracture Type IIIB


    >10cm
    High
    Severe loss of coverage,
    moderate periosteal stripping

    Open Fracture Type IIIC


    >10cm
    High
    Very severe loss of coverage,
    severe periosteal stripping,
    vascular injury requiring repair
    Usually comminuted
    poor bone coverage
    requires soft tissue
    reconstruction
    Out-in

    Moderate
    comminution

    Usually comminuted
    soft tissue coverage possible

    Out-In

    Out-in
    *For type III(ABC)
    antibiotics, if Severe
    contamination or Farm
    injury add Penicillin or
    Metronidazole

    Usually Comminuted
    poor bone coverage
    requires soft tissue
    reconstruction
    Out-in
    Cannot be closed primarily,
    Requires external fiaxator
    and a flap to cover it

    1-2L NSS

    1st Gen Cephalosporin


    (Cefazolin)
    +
    Aminoglycoside
    (Neomycin, Amikacin)
    5-10L NSS

    1st Gen Cephalosporin


    (Cefazolin)
    +
    Aminoglycoside (Neomycin,
    Amikacin)
    5-10L NSS

    1st Gen Cephalosporin


    (Cefazolin)
    +
    Aminoglycoside (Neomycin,
    Amikacin)
    5-10L NSS

    1st Gen Cephalosporin


    (Cefazolin)
    +
    Aminoglycoside (Neomycin,
    Amikacin)
    5-10L NSS

    Stable: Casting/ Spint


    Intramedullary
    Nailing

    Intramedullary Nailing
    *External fixation for
    some

    External Fixation

    External Fixation

    External Fixation

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