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Table 3-3

Factors that Modify Open Fracture Classification Regardless of Initial Skin Defect

Contamination
  • Exposure to soil
  • Exposure to water (pools, lakes/streams)
  • Exposure to fecal matter (barnyard)
  • Exposure to oral flora (bite)
  • Gross contamination on inspection
  • Delay in treatment >12 h
Signs of High-Energy Mechanism
  • Segmental fracture
  • Bone loss
  • Compartment syndrome
  • Crush mechanism
  • Extensive degloving of subcutaneous fat and skin
  • Requires flap coverage (any size defect)