Gustilo-Anderson Classification (Open Fractures)
Classifies open fractures by wound size and contamination level. Guides antibiotic choice and surgical management.
Score interpretation
→ IV co-amoxiclav as soon as possible, ideally within 1 hour of injury; wound excision within 24 hours of injury (NICE NG37); primary closure may be possible
→ IV co-amoxiclav + gentamicin + metronidazole; ortho-plastics team; wound excision within 12 hours of injury, immediately if highly contaminated; fixation and definitive soft tissue cover at that operation or within 72 hours (NICE NG37)
→ Immediate vascular surgery; amputation rate 25-90%; aggressive antibiotics; MESS score assessment
Interpretation bands for the Gustilo Classification. Apply clinical judgement and local guidance.
References
Related
Curated clinical cross-links plus same-class fallbacks.
- Co-amoxiclav (Open Fracture Antibiotic Prophylaxis) · Beta-lactam / Beta-lactamase Inhibitor Combination
- Vancomycin (Orthopaedic Bone and Joint Infections) · Glycopeptide Antibiotic
- Gentamicin (Orthopaedic — Bone Cement and Systemic) · Aminoglycoside Antibiotic
- Teicoplanin (Orthopaedic Bone and Joint Infections) · Glycopeptide Antibiotic
- Ciprofloxacin (Orthopaedic — Gram-negative Osteomyelitis) · Fluoroquinolone Antibiotic
- Piperacillin-Tazobactam (Polymicrobial Open Fracture Infections) · Extended-spectrum Beta-lactam / Beta-lactamase Inhibitor
- Hip Fracture Pathway · NICE CG124; BPT
- Cauda Equina Syndrome · Society of British Neurological Surgeons; BOA — Best Practice
- Knee Soft Tissue Injury (ACL / MCL / Meniscus) · BOA; Royal College of Surgeons
- Shoulder Dislocation · BOA; RCEM
- Scaphoid Fracture · BOA; BSSH
- Pelvic Fracture · BOA; ATLS; NICE NG39
Decision support only — verify against a current formulary, NICE, or your local guideline before clinical use.