ReviewJournal of clinical orthopaedics and trauma2021
The evidence base for 2017 BOAST-4 guidance on open fracture management: Are we due an update?
Review in Journal of clinical orthopaedics and trauma, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 5 papers, 1 of them a synthesis that pooled it.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
5 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Defining orthoplastic limb salvage centers: a systematic review.Archives of orthopaedic and trauma surgery · 2026Pooled it
- Early Flap Reconstruction and Infection Rates in Open Lower Extremity Fractures: A Systematic Review and Meta-analysis.Plastic and reconstructive surgery. Global open · 2025Article
- Orthoplastics Management of Open Lower Limb Fractures at a Major Trauma Centre: Audit of Adherence to BOAST4 Guidelines.JPRAS open · 2024Article
- Monolateral external fixation versus internal fixation of Gustilo IIIB open tibial fractures: a multicenter comparative study.European journal of trauma and emergency surgery : official publication of the European Trauma Society · 2024Article
- Quotation errors related to the wound management of open lower limb fractures (WOLLF) randomized clinical trial.European journal of orthopaedic surgery & traumatology : orthopedie traumatologie · 2023Review
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
3 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
introductionOpen fracture management in the United Kingdom and several other countries is guided by the British Orthopaedic Association's Standards for Trauma Number 4 (BOAST-4). This is updated periodically and is based on the best available evidence at the time. The aim of this study is to evaluate the evidence base forming this guidance and to highlight new developments since the last version in 2017.
methodsSearches have been performed using the PubMed, Embase and Medline databases for time periods a) before December 31, 2017 and from 01/01/2018-01/02/2021. Results have been summarized and discussed. DISCUSSION: Several contentious issues remain within the 2017 guideline. Antibiotic guidance, the use of antibiotic impregnated PMMA beads and intramedullary devices, irrigation in the emergency department, time to theatre and the use of negative pressure dressings and guidance regarding the management of paediatric injuries have all demonstrated no clear consensus.
conclusionThe advent of the BOAST-4 guideline has been of huge benefit, however the refinement and improvement of this work remains ongoing. There remains a need for further study into these contentious issues previously listed.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.