Pin tract infections: silver vs uncoated pins.
To test the hypothesis that coating external fixation pins with a silver-containing compound (Spi-Argent, Spire Corp, Bedford, Mass) will reduce bacterial colonization and/or pin tract infection, 36 silver-coated and 12 conventional stainless steel pins were placed in the iliac crest of six sheep and inoculated with Staphylococcus aureus. After 2 1/2 weeks the pin sites were examined for motion and inflammation, and the pin tips were quantitatively cultured and examined with scanning electron microscopy (SEM). We found that 84% of the uncoated pins were infected, while 62% of the silver-coated pins were infected. Silver-coated pins were less frequently infected than uncoated pins (confidence interval [CI] > 85%). Also, silver-coated pins were loose less frequently than uncoated pins. Pin motion was closely correlated with infection: 28 of 32 infected pins (88%) had motion, while only 9 of 16 uninfected pins (56%) had motion (CI > 80%). SEM study of the pin tips showed a decreased level of glycocalyx-protected colonization on the surface of the silver-coated pins. Clinically, these results suggest that silver-coated pins will result in less infection and motion at the pin site, the most significant problems in external fixation.
Dept of Orthopedic Surgery, University of Louisville, KY 40292.
C A
CA
Collinge
G
G
Goll
D
D
Seligson
K J
KJ
Easley
D000818:Animals; D001419:Bacteria / Q000302:isolation & purification*; D001858:Bone Nails / Q000009:adverse effects*; D004866:Equipment Contamination; D016267:External Fixators / Q000009:adverse effects*; D012756:Sheep; D012834:Silver; D013530:Surgical Wound Infection / Q000382:microbiology* / Q000517:prevention & control
D012834:Silver