AAOS American Academy of Orthopaedic Surgeons

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Guideline

DoD/METRC Project

APPROPRIATE USE CRITERIA: Prevention of Surgical Site Infection After High Energy Extremity Trauma (2022)

Endorsed by: ASES, POSNA, AOFAS, SIS, IDSA, OTA

INDICATION PROFILE

Injury Classification

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Closed
Gustilo Anderson Type 1 or 2
Gustilo Anderson Type 3a
Gustilo Anderson Type 3b, c

Soft Tissue Characteristic(s)

Closed Injury: Significant Soft Tissue Compromise
Open Injury: Minimal/None Surface Contamination; Superficial Penetrating Injury
Open Injury: Severe contamination; Marine environment; Military blasts; High Energy Penetrating Injury; Crush injury; Compartment Syndrome

Host Factors/Medical Status

No or Limited Comorbidities (healthy, ASA 1-2, Charlson Index <3)
Multiple Comorbidities (frail, ASA 3-4, Charlson Index >4)

Surgical Treatment Adminstered

Acute Definitive Internal Fixation (ORIF/IMN)
Acute Definitive External Fixator
Temporary Acute External Fixator, With Plan for Staged Definitive Internal Fixation (ORIF/IMN)

PROCEDURE RECOMMENDATIONS

Treatment recommendations are not available for this patient scenario.