Aspetti organizzativi e timing
Abstract
TIMING AND SETTING
Open fractures are often caused by high-energy trauma and the trauma itself is a relevant problem in the approach to
these fractures. Major trauma may lead to significant long-term morbidity and disability. The fracture itself may
induce prolonged illness lasting up to 2 years after the event. Open fractures are defined as bone fractures associated
with solution of continuity of the surrounding soft tissue, which puts into communication the external environment
and the bone or haematoma derived from the fracture. This communication with the external environment may lead
to higher infection rates, malunion and nonunion if not recognised and treated appropriately. Before 1850, most
surgeons used to treat open fractures with early limb amputation, since sepsis and gangrene were common side-effects,
which often lead to death. It was not until the early twentieth century that sterility techniques became widely
accepted, in part thanks to the work of English surgeon Joseph Lister. Known as the father of sterile surgery, Lister was
the first to recognise the importance of sterile techniques during surgery. This way, he managed to reduce mortality
rates dramatically, from 25–50% to 9%. Today, more than a century later, although open fractures are no longer a
cause of mortality, they are still the source of significant morbidity and disability following trauma.
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This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.
Copyright
© Società Italiana Ortopedici Traumatologi Ospedalieri d’Italia 2019 , 2019
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