Infections in orthopaedic and trauma surgery can be hard to treat and have a higher risk of recurrence. Fractures with closed soft tissue damage and open fractures are more likely to have an infection during the course of treatment. For that reason, from the early start of fracture treatment, effort should be given to the most optimal care for the soft tissue as well as fracture stabilisation. An open fracture Grade II and III according to Gustilo-Anderson has a high incidence of bacterial contamination, followed by infection, which can lead to an acute or late onset of osteomyelitis. Skin bacteria and environmental germ species are playing an important role in the case of delayed fracture healing and frequently causing an infection-related biofilm formation on osteosynthesic and prosthesic hardware. For that reason, early (temporary) antibiotic administration as soon as the fracture treatment starts is of high relevance. Early surgical debridement under sterile conditions in the operation theatre, combined with lavage and, for example the use of negative pressure wound therapy, can significantly reduce the risk of an acute or late onset of a surgical site infection. Patient’s outcome can be improved by following surgical guidelines from the early start of fracture care and, if successfully performed, can result in a lower number of surgeries needed to heal trauma-related soft tissue damage with timely consolidation of the fracture. By consequence, a shorter hospital stay can be achieved, reducing financial costs.