This propensity-matched cohort study from a level-I trauma center asks whether primary wound closure after debridement of Gustilo-Anderson grade-I, II, and IIIA open fractures is safer than the traditional strategy of delayed closure. By matching 73 pairs of patients on injury severity, contamination, fracture grade, and other prognostic factors, the authors isolate the effect of closure timing on deep-infection risk.
When you see a Gustilo-Anderson grade-I, II, or IIIA open fracture with adequate debridement by an experienced surgeon, primary wound closure is not only acceptable — this data suggest it may actively reduce deep-infection risk compared with routine delayed closure.
Reserve delayed closure for wounds with residual contamination, inadequate debridement, or higher-grade injuries where primary closure is anatomically or biologically precluded.
This propensity-matched cohort study from a level-I trauma center asks whether primary wound closure after debridement of Gustilo-Anderson grade-I, II, and IIIA open fractures is safer than the traditional strategy of delayed closure. By matching 73 pairs of patients on injury severity, contamination, fracture grade, and other prognostic factors, the authors isolate the effect of closure timing on deep-infection risk.
When you see a Gustilo-Anderson grade-I, II, or IIIA open fracture with adequate debridement by an experienced surgeon, primary wound closure is not only acceptable — this data suggest it may actively reduce deep-infection risk compared with routine delayed closure.
Reserve delayed closure for wounds with residual contamination, inadequate debridement, or higher-grade injuries where primary closure is anatomically or biologically precluded.