title: Pin site care in external fixation sodium chloride or chlorhexidine solution as a cleansing agent.
abstract: BACKGROUND
  Pin site infection is the most common complication using external fixators. This study investigated the differences in pin site infections, antibiotic use, pain, and complications using sodium chloride and chlorhexidine solution as cleansing agent in patients operated on by the hemicallotasis technique for knee deformities.
  
  
  METHODS
  The prospective study included 49 consecutive patients: 2 mg/ml chlorhexidine solution was used as cleansing agent in 30 patients (120 pins) and 9 mg/ml sodium chloride in 19 patients (76 pins). We evaluated the status of the pin sites, pain (VAS), uses of antibiotic and analgesic agents, and any complications (infections were graded according to the Checketts-Otterburns classification). Bacterial cultures were performed from each pin site at 1, 6, and 10 weeks and from the pins at removal.
  
  
  RESULTS
  Grade 1 infection was found in 14% of the sodium chloride group and in 8.5% of the chlorhexidine group, and grade 2 infection in and 3% and 0.5%, respectively. With sodium chloride there was a significantly higher relative risk for positive cultures (1.7) and for the presence of Staphylococcus aureus (3.3). The chlorhexidine group required significantly fewer antibotics reported significantly less pain at weeks 6 and 10.
  
  
  CONCLUSIONS
  Chlorhexidine solution (2 mg/ml) as cleansing agent in pin site care is preferable to sodium chloride in patients operated on by the hemicallotasis technique.
authors.affiliation: Department of Orthopedics, University Hospital, 22185 Lund, Sweden. annette.w-dahl@ort.lu.se
authors.forename: Annette
authors.initials: A
authors.lastname: W-Dahl
authors.forename: Sören
authors.initials: S
authors.lastname: Toksvig-Larsen
mesh_terms: D000328:Adult; D000368:Aged; D000891:Anti-Infective Agents, Local / Q000627:therapeutic use*; D001858:Bone Nails / Q000382:microbiology*; D002710:Chlorhexidine / Q000627:therapeutic use*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010147:Pain Measurement; D011446:Prospective Studies; D012965:Sodium Chloride; D013530:Surgical Wound Infection / Q000517:prevention & control*
chemical_list: D000891:Anti-Infective Agents, Local; D012965:Sodium Chloride; D002710:Chlorhexidine