{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,22]],"date-time":"2026-10-22T08:55:18Z","timestamp":1792659318821,"version":"4.5.0"},"reference-count":76,"publisher":"Bentham Science Publishers Ltd.","issue":"1","license":[{"start":{"date-parts":[[2014,6,27]],"date-time":"2014-06-27T00:00:00Z","timestamp":1403827200000},"content-version":"unspecified","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/2.5\/"}],"content-domain":{"domain":["openorthopaedicsjournal.com","benthamopen.com"],"crossmark-restriction":true},"short-container-title":["TOORTHJ"],"published-print":{"date-parts":[[2014,6,27]]},"abstract":"<jats:p>Open fractures are a common problem encountered by orthopaedic surgeons and comprise a broad spectrum of trauma. Management is guided by principle-based steps aimed at reducing the risk of gas gangrene or suppurative infections, whilst maintaining viability in a favourable soft tissue environment to reduce the risk of delayed or non-union of bone. Aspects of these principles, however, create discussion around several areas of controversy. The specific antimicrobial regimen and its duration are questions that have been evaluated for decades. Like the ever-evolving nature of the bacterial pathogens, the answer to this is dynamic and changing. The \u201csix-hour rule\u201d is a hotly debated topic with fervent perseverance of this dogma despite a gross lack of support from the literature. The most appropriate soft tissue management approach for open fractures \u2013 immediate definitive soft tissue closure versus leaving wounds open for delayed closure or definitive management \u2013 is also an area of debate. Exploration of these controversies and consideration for the historical context of the supporting literature furthers our understanding of the critical elements.<\/jats:p>","DOI":"10.2174\/1874325001408010178","type":"journal-article","created":{"date-parts":[[2014,7,17]],"date-time":"2014-07-17T08:18:20Z","timestamp":1405585100000},"page":"178-184","update-policy":"https:\/\/doi.org\/10.2174\/crossmark_policy","source":"Crossref","is-referenced-by-count":30,"title":["Controversies in the Management of Open Fractures"],"prefix":"10.2174","volume":"8","author":[{"given":"O\u2019Brien","family":"C.L","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Menon","family":"M","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jomha","family":"N.M","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"965","reference":[{"key":"refR1","unstructured":"Advanced Trauma Life Support Student Course Manual In: American College of Sureons. 8th ed.. 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