A review is given of 38 patients with open fractures who are operatively treated in our hospital from 1973 to 1987. Treatment principles consisted in primary wound cleansing, primary definitive internal fixation of fracture, and primary or delayed primary closure of wound. It is acceptable to do primary closure when wound is clean and without extensive soft tissue damage. But when a operator is unsure of wound status, it is recommended to do delayed primary closure. Our “Delayed Primary Method” is to dress the wound with packed gauge with a tube for injecting antibiotics. For about a week antibiotics is injected 3 or 4 times a day, and then wound is closed by suture or skin graft. As a result, 11 patients required secondary operation for delayed-union but no patient became infected. Generaly speaking, “primary internal fixation” has many advantages, but it increases the risk of infection. But using “Delayed Primary Method”, we can do “primary internal fixation” without increasing the risk of infection.
