Pin site care during circular external fixation using two different protocols.
OBJECTIVE
Treatment of tibial fractures with Ilizarov external fixation is a valuable treatment alternative; however, development of problems at the pin site is one of the major drawbacks of this technique. Moreover, there is no general agreement regarding pin site care. The purpose of this study was to compare the efficacy of two different pin site care techniques after treatment of tibial fractures with an Ilizarov external fixator.


METHODS
Prospective randomized study.


METHODS
Department of Orthopaedic Surgery of education and research hospital.


METHODS
In this prospective randomized study, we followed up 610 pin sites in 39 cases using two different pin site care protocols.


METHODS
For the first 15 days, patients in both groups cleaned each pin site using sterile gauze impregnated with 10% polyvinylpyrrolidone iodine (Polyod) every 3 days. After 15 days, patients in group 1 (20 cases, 310 pin sites) were advised to perform pin care by daily showering and brushing the pin sites with soap and an ordinary soft toothbrush, whereas patients in group 2 (19 cases, 300 pin sites) were advised to perform pin care by daily showering and cleaning the crusts using sterile gauze impregnated with 10% polyvinylpyrrolidone iodine (Polyod). Each pin site was denominated according to location.


METHODS
Pin sites were inspected and graded on a scale of 0 to 5 according to slight modification of the system of Dahl described by Gordon et al during outpatient visits on the 5th, 10th, 15th, 30th, 45th, 60th, 75th, 90th, 120th, and 150th days of follow up after the operation until fixator removal. Grade 1 and grade 2 infections were categorized as minor infection not requiring any extra pin site care and grade 3 and above infections as major infection.


RESULTS
Minor infection rate of all pin sites was determined as 50.7% in group 1 and 43.6% in group 2. Major infection rate was determined as 3.5% in group 1 and 3.7% in group 2. No statistically significant difference was noted between the two groups (all P > 0.05).


CONCLUSIONS
Pin site care can be performed without impairing patient comfort and without prohibition of showering. Pin site care can be self-managed by the patients without complex sterilization techniques.
Ministry of Health, Ankara Training and Research Hospital, 1st Clinic of Orthopaedics and Traumatology, Ulucanlar, Ankara, Turkey. turgaycavusoglu@yahoo.com
Ali Turgay
AT
Cavusoglu
Mehmet Serhan
MS
Er
Sermet
S
Inal
Mehmet Hakan
MH
Ozsoy
Veysel Ercan
VE
Dincel
Abdurrahman
A
Sakaogullari
D000900:Anti-Bacterial Agents / Q000008:administration & dosage*; D001858:Bone Nails / Q000009:adverse effects*; D005260:Female; D006801:Humans; D018889:Ilizarov Technique / Q000295:instrumentation*; D008297:Male; D008875:Middle Aged; D016459:Prosthesis-Related Infections / Q000209:etiology* / Q000517:prevention & control*; D013242:Sterilization / Q000379:methods*; D013978:Tibial Fractures / Q000150:complications / Q000601:surgery*; D016896:Treatment Outcome
D000900:Anti-Bacterial Agents