54. Wound excision Wound excision to be under taken under strict aseptic condition, must be systematic and complete. Lavage is done with normal saline or distilled water. For final irrigation mixture of bacitracin and polymyxin solution is preferable. Wound incision must be large enough to facilitate exposure and inspection. The following structures are debrided : skin, fascia and tendons,muscles, and bones.
95. For type III B and III C open fracture with significant soft tissue loss and exposed bone often require two or three debridement before flap coverage.Early soft tissue converge is key to minimize woundsepsis.