Changing paradigms in the management of Open Injuries

Vol 2 | Issue 2 | July – Dec 2017 | Page 5-10 | Dheenadhayalan Jayaramaraju, Sivakumar SP, Raja Bhaskara Kanakeshwar, Devendra Agraharam, Ramesh Perumal, Arun Kamal C, Rajasekaran Shanmuganathan

Authors: Dheenadhayalan Jayaramaraju [1], Sivakumar SP [1], Raja Bhaskara Kanakeshwar [1], Devendra Agraharam [1], Ramesh Perumal [1], Arun Kamal C [1], Rajasekaran Shanmuganathan [1]

[1] Department of Orthopaedics & Trauma, Ganga Medical Centre & Hospitals Pvt. Ltd, Coimbatore, Tamil Nadu

Address of Correspondence
Dr Raja Bhaskara Kanakeshwar
Ganga Hospital, Coimbatore
Email :


Open injuries still pose a major problem as they are prone to higher rates of infection and non-union and are usually associated with life threatening polytrauma. Nowadays, specialized trauma centres and a multimodal team approach have shown to give superior results in the outcome following open injuries. Early aggressive wound debridement followed by early fracture stabilization with early wound closure to achieve bone and soft tissue healing are important components as nowadays we focus on the ‘Era of functional restoration’. Serum Lactate is a widely used biochemical marker to assess the adequacy of tissue resuscitation and the Ganga Hospital Open Injury score (GHOIS) has a higher specificity towards limb salvage and also gives guidelines regarding timing and type of soft tissue reconstruction. A combined ‘Orthoplastic’ approach in the management of open injuries and adherence to the ‘revised reconstruction ladder’ with regarding to wound coverage has shown to a favourable outcome.
Keywords : Open fractures, Debridement, Serum lactate, Ganga Hospital Open Injury score.


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How to Cite this article: Dheenadhayalan J, Sivakumar SP, Kanakeshwar RB, Agraharam D, Perumal R, Arun KC, Rajasekaran S. Changing paradigms in the management of Open Injuries. Journal of Clinical Orthopaedics July-Dec 2017; 2(2): 5-10.

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