title: Antimicrobial efficacy of external fixator pins coated with a lipid stabilized hydroxyapatite/chlorhexidine complex to prevent pin tract infection in a goat model.
abstract: BACKGROUND
  Pin tract infection is a common complication of external fixation. An antiinfective external fixator pin might help to reduce the incidence of pin tract infection and improve pin fixation.
  
  
  METHODS
  Stainless steel and titanium external fixator pins, with and without a lipid stabilized hydroxyapatite/chlorhexidine coating, were evaluated in a goat model. Two pins contaminated with an identifiable Staphylococcus aureus strain were inserted into each tibia of 12 goats. The pin sites were examined daily. On day 14, the animals were killed, and the pin tips cultured. Insertion and extraction torques were measured.
  
  
  RESULTS
  Infection developed in 100% of uncoated pins, whereas coated pins demonstrated 4.2% infected, 12.5% colonized, and the remainder, 83.3%, had no growth (p < 0.01). Pin coating decreased the percent loss of fixation torque over uncoated pins (p = 0.04).
  
  
  CONCLUSIONS
  These results demonstrate that the lipid stabilized hydroxyapatite/chlorhexidine coating was successful in decreasing infection and improving fixation of external fixator pins.
authors: Extremity Trauma Study Branch, U.S. Army Institute of Surgical Research, Brooke Army Medical Center, Fort Sam Houston, Texas 78234-6200, USA.
authors: E S
authors: ES
authors: DeJong
authors: T M
authors: TM
authors: DeBerardino
authors: D E
authors: DE
authors: Brooks
authors: B J
authors: BJ
authors: Nelson
authors: A A
authors: AA
authors: Campbell
authors: C R
authors: CR
authors: Bottoni
authors: A E
authors: AE
authors: Pusateri
authors: R S
authors: RS
authors: Walton
authors: C H
authors: CH
authors: Guymon
authors: A T
authors: AT
authors: McManus
mesh_terms: D000818:Animals; D000891:Anti-Infective Agents, Local / Q000494:pharmacology*; D001858:Bone Nails; D016009:Chi-Square Distribution; D002710:Chlorhexidine / Q000494:pharmacology*; D020099:Coated Materials, Biocompatible; D020878:Device Removal; D004195:Disease Models, Animal; D017886:Durapatite / Q000494:pharmacology*; D016267:External Fixators; D005592:Fracture Fixation / Q000295:instrumentation*; D006041:Goats; D008297:Male; D013193:Stainless Steel; D013203:Staphylococcal Infections / Q000517:prevention & control*; D018709:Statistics, Nonparametric; D013978:Tibial Fractures / Q000628:therapy*; D014025:Titanium; D019415:Torque
chemical_list: D000891:Anti-Infective Agents, Local; D020099:Coated Materials, Biocompatible; D013193:Stainless Steel; D017886:Durapatite; D014025:Titanium; D002710:Chlorhexidine