The ideal method of irrigation and débridement for severe extremity wounds has yet to be determined. This report demonstrates the use of hydrosurgical débridement in the treatment of highly contaminated acute forearm fractures in a 22-year-old man ejected during a motor vehicle crash in a farm area. The result was rapid, selective, and effective débridement of deeply embedded material, which allowed for expeditious reconstruction with internal fixation, tendon transfers, and groin flap coverage while avoiding infection and injury to vital structures. The technique is described in detail and the current literature is reviewed.