A
Within 24 hours of injury
B
Between 14 and 21 days post-injury
C
Within 5 to 7 days post-injury
D
After 4 weeks, once healthy granulation tissue has fully filled the defect
Explanation:The correct option is 'c'. The widely accepted standard established by Godina for severe open fractures (Gustilo IIIB/IIIC) is that definitive soft-tissue coverage (local or free flap) should optimally be achieved within 5 to 7 days (or immediately if thoroughly debrided and clean). Coverage performed during the subacute phase (1-3 weeks) is associated with the highest rates of flap failure and deep infection due to bacterial colonization and wound fibrosis.
Reference: Godina M. Early microsurgical reconstruction of complex trauma of the extremities. Plast Reconstr Surg. 1986;78(3):285-292.