When to do Debridement?


The Relationship Between Time to Surgical Débridement and Incidence of Infection After Open High-Energy Lower Extremity Trauma

Andrew N. Pollak, MD1, Alan L. Jones, MD2, Renan C. Castillo, MS3, Michael J. Bosse, MD4, Ellen J. MacKenzie, PhD3 and the LEAP Study Group

1University of Maryland School of Medicine, 22 South Greene Street, Suite T3R54, Baltimore, MD 21201. E-mail address: apollak@umoa.umm.edu

2 Orthopedic Trauma Associates of North Texas, Sammons Tower, 3409 Worth Street, Suite 320, Dallas, TX 75246

3 Center for Injury Prevention and Research, Johns Hopkins University Bloomberg School of Public Health, 624 North Broadway Street, Room 482, Baltimore, MD 21205 4 Department of Orthopaedic Surgery, Carolinas Medical Center, P.O. Box 32861, Charlotte, NC 28232

The Journal of Bone and Joint Surgery (American). 2010;92:7-15.


  • The time from the injury to operative débridement is not a significant independent predictor of the risk of infection.
  • The found that timely admission to a definitive trauma centre has a beneficial effect to reduce the rate of infection

Full text: http://www.ejbjs.org/cgi/content/full/92/1/7

Commentary: http://www.ejbjs.org/Comments/2010/cp_jan10_schmidt.dtl


  1. bimal says

    hitesh, may be a retrospective study can be done in medical trust say for last few yrs…may be a case control where the infected open fractures can be looked into…or a cohort if the open fractures can be categorized based on severity, delay, fixation etc….wht u think bt it..
    most of this literature is western based…dunno how much we can apply them in our conditions

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