Introduction. In addition to an adequate initial treatment in open fractures, wound care also has a very important role to control infections that occur in the wound. There are various efforts to reduce the incidence of infection through the improvement of wound care techniques or materials used wound dressings. One method to treat an open fracture wounds is a bioceramic. The objective of the study is to determine the comparative effectiveness of using bioceramic compared with physiological saline moist gauze to the number of colonies of bacteria in the wound dressings, after wound debridement on lower leg open fractures grade IIIA. Materials and methods. The design of this study is to design randomized clinical trials comparing simple method of treatment of lower leg open fracture wounds grade IIIA using bioceramic compared using physiological saline moist gauze in a row at the emergency ward of Dr. Hasan Sadikin Hospital from December 2010 until April 2011. The research was divided into two groups, the first group was given preferential treatment with bioceramic wound care (n = 13 patients) and a second group performed wound care with moist gauze physiological saline (n = 13 patients). Examination of materials obtained from the wound bed, then a head count of the number of bacteria colonies at the Laboratory of Microbiology Faculty of Medicine Universitas Padjadjaran. Results. The results of treatment of wounds with bioceramic with mean percentage reduction in the number of bacteria colonies was 84.3 after 2 days of treatment and 83.4 after 7 days of treatment. While the group treated the wound with moist gauze physiological saline, the mean percentage reduction in the number of bacteria colonies were 78.3 and 75.6 after 2 and 7 days of treatment respectively. The results of statistical analysis using parametric statistical test t-test showed significant differences value with p <0.01 Conclusions. The use of bioceramic on the treatment of post-debridement wound open long bone fractures grade IIIA will provide better results to the decline in the number of colonies of bacteria.