DEBRIDEMENT

Thorough inspection of the wounds with liberal use of surgical enlargement (i.e. wide surgical exposure) is necessary to inspect all levels of tissue, including examination of fascial planes and the integrity of neurovascular structures. This may require extension to outside the zone of trauma. When extending the wound into healthy tissue, consideration should be given to how this could potentially affect future reconstructive or closure options.4 In general, extremity wounds should be extended in a longitudinal manner (parallel with the bone) and truncal wounds should be extended along Langer’s lines (see figure below). Wound configuration and need for additional vascular exposure must be considered and this may at times violate all of the above precepts.