Gustilo-Anderson classification of open fractures

vigente

Grades open (compound) fractures by wound size, soft-tissue injury, contamination, and vascular status to guide antibiotics and predict infection.

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Escala de categorias

I II IIIA IIIB IIIC

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Procedência e vigência

Órgão emissor: Gustilo & Anderson
Versão: 1984 (Gustilo-Mendoza-Williams)
Ano: 1976
Família: léxico
Tipo de lógica: flat
Modalidade: XR, CT
Fonte primária: Open Fracture Management (StatPearls)
Última verificação: 2026-06-26
Última checagem: 2026-06-26

Lógica de decisão

Forma estruturada (flat). Uma futura calculadora a lê; as categorias abaixo são a superfície legível.

Mostrar a lógica estruturada (JSON)

{
  "categories": [
    "I",
    "II",
    "IIIA",
    "IIIB",
    "IIIC"
  ]
}

Categorias num relance

Cat.	Significado	Conduta	Risco	Fonte
I	Type I Low-energy open fracture with a clean wound under 1 cm and minimal soft-tissue damage.	Gram-positive coverage (e.g. cefazolin or cefuroxime) plus irrigation and debridement.	—	okfonte StatPearls 'Open Fracture Management' (NBK448083), classification/wound-examination text: type I = low energy, wound <1 cm, minimal soft-tissue damage; gram-positive antibiotic coverage.
II	Type II Low-to-moderate energy open fracture with a wound greater than 1 cm and moderate soft-tissue and muscle damage.	Gram-positive antibiotic coverage, as for type I, with irrigation and debridement.	—	okfonte StatPearls NBK448083, classification text: type II = low-to-moderate energy, wound >1 cm, moderate soft-tissue/muscle damage; gram-positive coverage.
IIIA	Type IIIA High-energy open fracture with a wound usually greater than 10 cm or severe crushing soft-tissue damage, but with adequate soft-tissue coverage of the exposed bone.	Add gram-negative coverage (e.g. an aminoglycoside such as gentamicin) to gram-positive coverage; high-dose penicillin if fecal/clostridial contamination is suspected.	—	okfonte StatPearls NBK448083: type III = high-velocity, wounds >10 cm; IIIA severe crushing soft-tissue damage; type III antibiotics add gram-negative (aminoglycoside) and penicillin for contamination.
IIIB	Type IIIB High-energy open fracture with significant loss of soft-tissue coverage and periosteal stripping, leaving exposed bone that requires a soft-tissue flap for coverage.	Gram-positive plus gram-negative coverage with irrigation/debridement; soft-tissue flap reconstruction for coverage.	—	okfonte StatPearls NBK448083: IIIB = significant loss of tissue coverage requiring a flap; type III combined gram-positive and gram-negative antibiotic regimen.
IIIC	Type IIIC Open fracture with an associated arterial injury requiring repair, regardless of wound size.	Gram-positive plus gram-negative coverage and urgent vascular repair.	By definition involves an arterial injury requiring repair, carrying the greatest limb-loss/amputation risk among the grades.	okfonte StatPearls NBK448083: IIIC = significant soft-tissue injury with vascular injury requiring repair; type III antibiotic regimen.

Histórico de versões

Data	Evento	Detalhe	Situação
1984-01-01	revised	Type III subdivided into IIIA, IIIB, and IIIC (Gustilo, Mendoza, Williams).	confirmado

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