Should open fracture wounds be closed primarily or closed secondarily? If closed primarily, which ones and under what criteria?

Authors: Nathan O’Hara, David Lowenberg, Robert O’Toole

RECOMMENDATION: Yes. Primary wound closure of many open fracture wounds appears to be a safe and likely beneficial strategy in the modern setting of improved debridement techniques, better methods of fracture stabilization, and improved utilization of early systemic antibiotic administration. It appears safe for lower grade open fractures and a subset of higher-grade open fractures when the wound is deemed appropriate for primary closure on a clinical basis.

LEVEL OF EVIDENCE: Moderate

DELEGATE VOTE: Agree: 100%, Disagree: 0%, Abstain: 0% (Unanimous, Strongest Consensus)

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