UNASSIGNED: Introduction The standards for the management of open @entity174 of the lower limb published by the British Association of Plastic, Reconstructive and Aesthetic surgeons (BAPRAS) and British Orthopaedic Association ( @entity15662 ) were introduced to improve the treatment received by @entity1 after open injury to the lower limb. These Standards were released after BAPRAS/ @entity15662 published Guidelines for the management of open @entity174 . Methods We wished to determine the impact of these Standards upon the surgical management of open @entity174 by comparing @entity1 admitted to an orthoplastic centre in the 45 months concluding December 2009 (the Guidelines era) with those admitted during 2011 (the Standards era). Surgical procedures required during the first 30 days and 12 months after injury were determined. Cases were divided into 'directly admitted @entity1 ' (DAP) and 'transferred @entity1 ' ( @entity68039 ). Standards-era @entity1 were divided further into those who had surgery exclusively at the orthoplastic centre (orthoplastic @entity1 (OPP)) and those transferred after surgery ( @entity68039 ). Results The number of @entity68039 trebled in frequency in the Standards era, 25% of whom were transferred before surgery. Significantly fewer surgical procedures were required for DAP and OPP groups compared with @entity68039 (and @entity68039 ) groups in both eras (Mann-Whitney U-test, p=0.05). DAP and OPP groups during the Standards era underwent the fewest procedures, with the vast majority of cases treated with two or fewer procedures in the first 12 months (88% and 80%, respectively, compared with 61% in the Guidelines era). In the Guidelines era, 44% of @entity68039 cases and in the Standards era 39% of @entity68039 and 29% of @entity68039 groups underwent two or fewer procedures. Approximately two-thirds of open @entity174 managed in our orthoplastic centre were @entity1 transferred after surgery. The greatest impact of the Standards was evident for those who underwent surgery exclusively in the orthoplastic centre, reflecting a more deliberate combined strategy. Conclusion These findings vindicate the Standards as well as mandating reorganisation and resourcing of orthoplastic services to ensure immediate transfer and early combined surgery. By increasing the capacity to deal with time-dependent initial surgery, the surgical burden that the @entity1 must endure, and which the service must provide, are reduced.

From guidelines to standards of care for open XXXX .

@entity1 :: ('9606', 'Species') :: ['patients', 'patient'] @entity15662 :: ('8574', 'Species') :: ['BOA'] @entity174 :: ('MESH:D050723', 'Disease') :: ['fractures', 'tibial fractures'] @entity68039 :: ('94031', 'Gene') :: ['TASP', 'TP']
@entity174 :: (MESH:D050723,Disease) :: ['tibial fractures']
