Pre-operative management of fracture blisters: a systematic review

Purpose: The pre-operative management of fracture blisters is an area of uncertainty within trauma and orthopaedic surgeries. Management strategies vary significantly between and within orthopaedic departments across the United Kingdom. The purpose of this systematic review was to comprehensively ap...

Full description

Saved in:
Bibliographic Details
Main Authors: Ishtar Redman, Kapil Sugand, Aashtad Daruwalla, Andrew Clark
Format: Article
Language:English
Published: Bioscientifica 2025-03-01
Series:EFORT Open Reviews
Subjects:
Online Access:https://eor.bioscientifica.com/view/journals/eor/10/3/EOR-2024-0074.xml
Tags: Add Tag
No Tags, Be the first to tag this record!
_version_ 1850072624282992640
author Ishtar Redman
Kapil Sugand
Aashtad Daruwalla
Andrew Clark
author_facet Ishtar Redman
Kapil Sugand
Aashtad Daruwalla
Andrew Clark
author_sort Ishtar Redman
collection DOAJ
description Purpose: The pre-operative management of fracture blisters is an area of uncertainty within trauma and orthopaedic surgeries. Management strategies vary significantly between and within orthopaedic departments across the United Kingdom. The purpose of this systematic review was to comprehensively appraise and synthesize the existing literature pertaining to this topic, highlighting current practices and areas for ongoing research. Methods: Extensive electronic literature searches were performed on PubMed/MEDLINE (January 1946–May 2024), Embase (January 1974–May 2024) and Cochrane library (January 1933–May 2024) databases. The search terms were as follows: (fracture blister OR bone blister*) AND (dress* OR drain* OR aspirat* OR deroof* OR manage*). These keywords were searched in the subject headings, in title and in abstract. Results: The results of the search methodology revealed five articles, which represented the best evidence to the clinical question. These papers reported on rates of wound healing and post-operative infection, time to surgical readiness and treatment costs, following varying treatment modalities in 1162 patients. The authors, publication dates, countries, patient groups, study outcomes and results of these papers are tabulated in Supplementary Table 1. Conclusion: Fracture blisters pose a significant challenge in clinical practice, leading to delays in surgery, suboptimal surgical approaches and complications in wound healing post-operatively. Currently, there is no consensus describing the optimal management of these blisters. This review challenges the conventional belief that fracture blisters are sterile, highlighting that the application of topical agents to the deroofed blister bed may expedite surgical readiness.
format Article
id doaj-art-c9059eb20b054f0a96a1fa0c863a5f8d
institution DOAJ
issn 2058-5241
language English
publishDate 2025-03-01
publisher Bioscientifica
record_format Article
series EFORT Open Reviews
spelling doaj-art-c9059eb20b054f0a96a1fa0c863a5f8d2025-08-20T02:47:03ZengBioscientificaEFORT Open Reviews2058-52412025-03-0110316617110.1530/EOR-2024-00741Pre-operative management of fracture blisters: a systematic reviewIshtar Redman0Kapil Sugand1Aashtad Daruwalla2Andrew Clark3Department of Trauma and Orthopaedic Surgery, University College London Hospitals NHS Foundation Trust, London, UKDepartment of Trauma and Orthopaedic Surgery, Royal National Orthopaedic Hospital, Stanmore, UKDepartment of Trauma and Orthopaedic Surgery, University College London Hospitals NHS Foundation Trust, London, UKDepartment of Trauma and Orthopaedic Surgery, Queen Elizabeth Hospital, Gateshead Health NHS Foundation Trust, Gateshead, UKPurpose: The pre-operative management of fracture blisters is an area of uncertainty within trauma and orthopaedic surgeries. Management strategies vary significantly between and within orthopaedic departments across the United Kingdom. The purpose of this systematic review was to comprehensively appraise and synthesize the existing literature pertaining to this topic, highlighting current practices and areas for ongoing research. Methods: Extensive electronic literature searches were performed on PubMed/MEDLINE (January 1946–May 2024), Embase (January 1974–May 2024) and Cochrane library (January 1933–May 2024) databases. The search terms were as follows: (fracture blister OR bone blister*) AND (dress* OR drain* OR aspirat* OR deroof* OR manage*). These keywords were searched in the subject headings, in title and in abstract. Results: The results of the search methodology revealed five articles, which represented the best evidence to the clinical question. These papers reported on rates of wound healing and post-operative infection, time to surgical readiness and treatment costs, following varying treatment modalities in 1162 patients. The authors, publication dates, countries, patient groups, study outcomes and results of these papers are tabulated in Supplementary Table 1. Conclusion: Fracture blisters pose a significant challenge in clinical practice, leading to delays in surgery, suboptimal surgical approaches and complications in wound healing post-operatively. Currently, there is no consensus describing the optimal management of these blisters. This review challenges the conventional belief that fracture blisters are sterile, highlighting that the application of topical agents to the deroofed blister bed may expedite surgical readiness.https://eor.bioscientifica.com/view/journals/eor/10/3/EOR-2024-0074.xmlfracture blistersbone blisterspre-operative managementderoofaspirationsilver sulfadiazeneserous blistershaemorrhagic blisters
spellingShingle Ishtar Redman
Kapil Sugand
Aashtad Daruwalla
Andrew Clark
Pre-operative management of fracture blisters: a systematic review
EFORT Open Reviews
fracture blisters
bone blisters
pre-operative management
deroof
aspiration
silver sulfadiazene
serous blisters
haemorrhagic blisters
title Pre-operative management of fracture blisters: a systematic review
title_full Pre-operative management of fracture blisters: a systematic review
title_fullStr Pre-operative management of fracture blisters: a systematic review
title_full_unstemmed Pre-operative management of fracture blisters: a systematic review
title_short Pre-operative management of fracture blisters: a systematic review
title_sort pre operative management of fracture blisters a systematic review
topic fracture blisters
bone blisters
pre-operative management
deroof
aspiration
silver sulfadiazene
serous blisters
haemorrhagic blisters
url https://eor.bioscientifica.com/view/journals/eor/10/3/EOR-2024-0074.xml
work_keys_str_mv AT ishtarredman preoperativemanagementoffractureblistersasystematicreview
AT kapilsugand preoperativemanagementoffractureblistersasystematicreview
AT aashtaddaruwalla preoperativemanagementoffractureblistersasystematicreview
AT andrewclark preoperativemanagementoffractureblistersasystematicreview