For an adult open fracture, which dressing is part of initial management?

• A. Moist sterile dressing
• B. Dry dressing
• C. Wet to dry gauze
• D. No dressing

Answer: (A)

The main idea here is protecting and preparing an open fracture wound for definitive treatment by creating a moist, sterile barrier. Using a sterile moist dressing over the wound helps prevent drying of tissue, reduces the chance of contaminant entry, and makes transport and later surgical debridement safer by preserving tissue viability and minimizing infection risk.

A dry dressing lacks moisture and can allow the wound surface to desiccate, which can impede healing and increase contamination risk. A wet-to-dry gauze approach, while historically used for debridement, can stick to viable tissue, cause pain, and remove healthy tissue during changes, which is not desirable in an open fracture. Leaving the wound uncovered (no dressing) also exposes it to the environment, increasing the risk of infection. So, applying a moist sterile dressing is the appropriate initial step to protect the wound while awaiting definitive care.