title: A prospective comparative study of pin site infection in pediatric supracondylar humeral fractures: daily pin care vs. no pin care.
abstract: BACKGROUND
  Pin site infection is a critical issue for patients' safety in skeletal fixation using percutaneous pins or wires. Closed reduction and percutaneous Kirschner wires fixation are the mainstay of treatment in pediatric supracondylar humeral fractures. Little information is available in the literature about the optimal regimen of pin site care in children.
  
  
  METHODS
  We performed a prospective comparative study of 61 children with supracondylar humeral fractures between June 2011 and March 2013 after approval by the institutional review board. They were allocated into two groups of different postoperative pin site care methods by the emergency department arrival date and received fracture fixation within 24 h. Postoperatively, 30 children underwent pin site cleaning every day whereas the other 31 patients did not have the pin sites cleaned until the pins removal 4-6 weeks later.
  
  
  RESULTS
  Demographic data were not significantly different between the two groups. The infection rate was significantly higher in patients who underwent daily pin site care (90.3 vs. 53.3 %, p = 0.001). Of the 144 pin sites, infection occurred at 42 (57.5 %) pin sites in the daily care group and at 19 (26.8 %) pin sites in the non-care group. The number of telephone consultations for postoperative care was significantly higher in the daily care group (1.0 vs. 0.27 call/case, p = 0.007).
  
  
  CONCLUSIONS
  Daily pin site care was associated with a higher infection rate and greater stress in postoperative care that required more telephone consultations. The study results could not support daily pin site care. Careful observation of pin sites was recommended in the treatment of pediatric supracondylar humeral fractures.
authors.affiliation: Department of Orthopedics, Chang Gung Memorial Hospital, 5, Fusing St., Gueishan Township, Taoyuan County, 33305, Taiwan.
authors.forename: Hsuan-Kai
authors.initials: HK
authors.lastname: Kao
authors.forename: Mei-Chuan
authors.initials: MC
authors.lastname: Chen
authors.forename: Wei-Chun
authors.initials: WC
authors.lastname: Lee
authors.forename: Wen-E
authors.initials: WE
authors.lastname: Yang
authors.forename: Chia-Hsieh
authors.initials: CH
authors.lastname: Chang
mesh_terms: D000293:Adolescent; D001858:Bone Nails; D001864:Bone Wires; D002648:Child; D002675:Child, Preschool; D005260:Female; D005592:Fracture Fixation / Q000295:instrumentation / Q000379:methods*; D006801:Humans; D006810:Humeral Fractures / Q000601:surgery*; D008297:Male; D059408:Pain Management; D011182:Postoperative Care / Q000379:methods*; D011446:Prospective Studies; D013530:Surgical Wound Infection / Q000453:epidemiology*; D016896:Treatment Outcome