 Soft tissue injury following an open fracture is a significant problem following surgical treatment of traumatic skeletal injuries. The soft tissue injury results from a combination of the initiating trauma and additional tissue injury during surgery. Current treatment includes open reduction and internal fixation versus external fixation, irrigation and debridement following admission, decreased activity non weight bearing status on the injured extremity, maintaining the patient as an inpatient in the hospital, repeated irrigation and debridements 36-72 hours following the initial trauma with concomitant wound culturing until which time it is determined that either delayed primary closure, or skin grafting withwithout flap coverage should be attempted. 