The authors felt that it would be an interesting and worthwhile exercise to examine the process and management of open long-bone fractures referred to East Grinstead as we felt that we were not achieving the timeframe, as advised by the BOA/BAPS guidelines.

Methods The notes of patients who were referred East Grinstead for soft tissue management of long-bone fractures were examined over a 1 year period and analysed. After the results were seen to be poor in terms of management, practices were changed and the following year’s patients’ management underwent the same analysis prospectively.

Results The first years audit revealed average day of referral of 6.1, day of transfer was 13.2 days and time to soft tissue coverage was 18.3 days. 8% of patients achieved the BOA/BAPS guidelines of coverage by day 5. The second cohort of patients showed little improvement in their process of care.