Читать книгу Fractures in the Horse - Группа авторов - Страница 63

A closed fracture is one in which the skin is intact over the fracture site, and an open fracture is one in which the skin is disrupted. However, intact skin that has been extensively bruised or stretched becomes less of a barrier to bacterial invasion. Open fractures carry a significantly poorer prognosis than those that are closed [172, 182, 186]. In one study, closed fractures were 4.2 times more likely to remain uninfected and horses were 4.6 times more likely to leave the hospital following internal fixation than open fractures [187]. A follow‐up retrospective study from the same institution did not find an association between open fractures and surgical site infection; however, the authors postulate that a relationship may have been missed due to the inclusion of fewer open fracture cases in the more recent study [188]. In human traumatology, open fractures are subdivided into types I–III based on the length of skin opening and soft tissue damage [171]. Most equine open fractures are type I (skin laceration <1 cm) or type II (larger skin laceration, but little tissue loss). Type III is defined as an open fracture with extensive lacerations, massive skin defects and gross contamination [180]. The majority of horses that sustain type III open fractures are euthanized without an attempt at repair [180].