title: Diluted povidone-iodine versus saline for dressing metal-skin interfaces in external fixation.
abstract: OBJECTIVE
  To compare infection rates associated with 2 dressing solutions for metal-skin interfaces.
  
  
  METHODS
  60 patients who underwent distraction osteogenesis with external fixators were equally randomised into 2 dressing solution groups (diluted povidone-iodine vs. saline). Fixations were attained using either rigid stainless steel 5-mm diameter half pins or smooth stainless steel 1.8-mm diameter wires. Half-pin fixation had one metal-skin interface, whereas wire fixation had 2 interfaces. Patients were followed up every 2 weeks for 6 months.
  
  
  RESULTS
  Of all 788 metal-skin interfaces, 143 (18%) were infected: 72 (19%) of 371 in the diluted povidone-iodine group and 71 (17%) of 417 in the saline group. Dressing solution and patient age did not significantly affect infection rates. Half-pin fixation was more likely to become infected than wire fixation (25% vs 15%).
  
  
  CONCLUSIONS
  Saline is as effective as diluted povidone-iodine as a dressing solution for metal-skin interfaces of external fixators. Saline is recommended in view of its easy availability and lower costs.
authors.affiliation: Department of Orthopaedic Surgery, Hospital Kuching, Malaysia.
authors.forename: C K
authors.initials: CK
authors.lastname: Chan
authors.forename: A
authors.initials: A
authors.lastname: Saw
authors.forename: M K
authors.initials: MK
authors.lastname: Kwan
authors.forename: R
authors.initials: R
authors.lastname: Karina
mesh_terms: D000293:Adolescent; D000328:Adult; D000367:Age Factors; D000368:Aged; D000891:Anti-Infective Agents, Local / Q000627:therapeutic use*; D001458:Bandages; D002648:Child; D002675:Child, Preschool; D016267:External Fixators; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007223:Infant; D008297:Male; D008875:Middle Aged; D019857:Osteogenesis, Distraction / Q000009:adverse effects* / Q000295:instrumentation*; D011206:Povidone-Iodine / Q000627:therapeutic use*; D013530:Surgical Wound Infection / Q000453:epidemiology / Q000517:prevention & control*; D055815:Young Adult
chemical_list: D000891:Anti-Infective Agents, Local; D011206:Povidone-Iodine