Photographic wound documentation after open fracture.

More than 3000 open fractures occur in UK each year. They require early assessment and meticulous treatment in order to avoid devastating complications. The British Orthopaedic Association and British Association of Plastic Surgeons Working Party recommend that an instant photograph be taken of an open wound prior to the application of a dressing. The dressing can then remain undisturbed until the definitive surgical debridement is performed in theatre. Such practice reduces nosocomial infection. Fifty-one accident and emergency departments were surveyed by the means of a telephone questionnaire. Forty-one percent were unable to photograph an open fracture wound. A further 20% had no access to a camera outside of office hours. The cheap, simple and effective recommendations of the Working party are not being followed.