1. Open fractures with an associated vascular deficit (Gustilo-Anderson Type IIIC).

2. Known allergy to detergents or castile soap ingredients.

3. Previous wound infection or history of osteomyelitis in the injured extremity.

4. Previous fracture with retained hardware in injured extremity that will interfere with new implant fixation.

5. Surgical delay to operative wound management greater than 24 hours from hospital admission.

6. Use of immunosuppressive medication within 6 months.

7. Immunological deficient disease conditions (e.g. HIV).

8. Fracture of the hand (metacarpals and phalanges).

9. Fracture of the toes (phalanges).

10. Likely problems, in the judgment of the investigators, with maintaining follow-up. We will, for example, exclude patients with no fixed address, those who report a plan to move out of town in the next year, or intellectually challenged patients without adequate family support.

11. Previous randomization in this study or a competing study.

Fluid Lavage of Open Wounds

What this study is about