Multicenter pin care study.
BACKGROUND
Pin-site infection is a common complication of external fixation. Because few studies have compared methods of pin care that reduce infection rate, there is a need for evidence-based practice guidelines for pin-site care.


METHODS
Two of 10 original clinical centers completed a prospective, randomized pin-care study between May 2000 and May 2002 to determine which of seven methods for caring for skeletal pins (external fixator, traction, or halo) resulted in the fewest pin-site infections.


RESULTS
The 92 subjects had an average infection rate of 34%, and the 527 pins had a rate of 20%. Thirty patients (98 pins) had stage II infections, two patients (12 pins) had stage III infections, and none had deep infection or osteomyelitis. The protocols were (1) half-strength peroxide cleansing and gauze wraps (45%), (2) half-strength peroxide cleansing and Xeroform wraps (9%), (3) saline cleansing and gauze wraps (33%), (4) saline cleansing and Xeroform wraps (26%), (5) antibacterial soap-and-water cleansing and gauze (38%), (6) antibacterial soap-and-water cleansing and Xeroform gauze (50%), and (7) stable dressings with no pin cleansing (36%). Logistic regression analysis demonstrated significant inverse relationships (p = .05) between infection rate and age, as well as fixator type; the latter may be related to exposed threads.


CONCLUSIONS
Results suggest that other factors outside the realm of this study may affect children's pin-site infection rate and that half-strength peroxide and Xeroform dressings were superior to soap-and-water cleansing. This pilot study indicates a need for further research with a larger sample size and for exploring factors in a younger population.
Patterson
Miki M
MM
Harvard Vanguard Medical Associates, Chelmsford, MA, USA.
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D001458:Bandages; D001858:Bone Nails; D002648:Child; D002675:Child, Preschool; D002985:Clinical Protocols; D004202:Disinfectants / Q000008:administration & dosage; D004989:Ethics; D005260:Female; D006801:Humans; D007239:Infections / Q000188:drug therapy / Q000453:epidemiology / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies
D000900:Anti-Bacterial Agents; D004202:Disinfectants