J. Nanchahal, S. Nayagam, U. Kahn, Ch. Moran, S. Barrett,
F. Sanderson, I Pallister, Standards for the management
of open fractures of the lower limb
Marston Book Services, Oxon, 2009, 112 pages, €25.00, ISBN: 978-1-85315-911-4
Received: 28 July 2010 / Accepted: 28 July 2010 / Published online: 25 August 2010
This paperback volume containing important new guide-
lines for obtaining optimal outcomes is endorsed by the
Councils of the British Association of Plastic, Recon-
structive and Aesthetic Surgeons and the British Ortho-
pedic Association. These new standards of care are an
essential reference for plastic, orthopedic, and emergency
medicine, as well as for rehabilitation specialists. This
book replaces previous guidelines in the UK and will
also have worldwide relevance.
The reader, with this paperback in hand, will
naturally look through the contents (20 chapters),
concentrating on how to deal with this complex matter.
Some of the titles are: primary management in the
emergency department, antibiotic prophylaxis, timing of
wound excision in open fractures, soft tissue temporary
wound dressings, degloving, timing of soft tissue
reconstruction, compartment syndrome, vascular injuries,
and when things go wrong with soft tissues. In addition,
titles on understanding bony injuries include: bone
exposure, classification of open fractures, techniques
for stabilization, when things go wrong with bone,
guidelines for primary amputation, and finally, outcome
measures with principal recommendations.
Each chapter is preceded by detailed principal recom-
mendations which are usually followed by a review and
discussion of the pertinent literature concerning the various
details of the injury. The necessary references are provided.
In addition, helpful, clear schematic drawings illustrate the
For this reviewer, having worked for years in an
emergency department and having cared for these demand-
ing open fractures of the lower limb, it is a pleasure to read
and reread this text devoted to multiple difficult problems.
This book is an excellent example of how specialists of
orthopedics and plastic surgery and all specialists of the
“hard and soft tissues” unite for setting standards—
minimizing complications and achieving optimal out-
comes—which is the aim of this book.
L. Clodius (*)
Eur J Plast Surg (2010) 33:321