title: Pin-site care: can we reduce the incidence of infections?
abstract: BACKGROUND
  This study was conducted to determine the pin-site care protocols currently in use and to analyse their effectiveness and outcomes.
  
  
  METHODS
  PubMed, the Cochrane Library and Embase databases were screened for manuscripts that described comparative studies of different methods of pin-site care and referred to complications related to any kind of external fixator application.
  
  
  RESULTS
  A total of 369 manuscripts were screened and only 13 of these met the inclusion criteria evaluating different protocols of pin-site care. This review is based on a total of 574 patients. Infection rates were very variable depending on the type of implant used and the protocol of pin-site care applied.
  
  
  CONCLUSIONS
  None of the different protocols of pin-site care that were evaluated in this study were associated with a 0% infection rate. There is currently no consensus in the international literature about which protocol should be applied universally. Meticulous surgical technique during pin insertion and implementation of one of the existing protocols of pin-site care are the mainstay of prevention and/or reduction of the incidence of pin-site infections.
authors.affiliation: Academic Department of Trauma & Orthopaedic Surgery, University of Leeds, Clarendon Wing, Floor A, Great George Street, Leeds General Infirmary, Leeds, LS1 3EX, UK.
authors.forename: Ioannis
authors.initials: I
authors.lastname: Ktistakis
authors.affiliation: Academic Department of Trauma & Orthopaedic Surgery, University of Malaga, Malaga, Spain.
authors.forename: Enrique
authors.initials: E
authors.lastname: Guerado
authors.affiliation: Academic Department of Trauma & Orthopaedic Surgery, University of Leeds, Clarendon Wing, Floor A, Great George Street, Leeds General Infirmary, Leeds, LS1 3EX, UK; NIHR Leeds Biomedical Research Unit, Chapel Allerton Hospital, Leeds, LS7 4SA, UK. Electronic address: pgiannoudi@aol.com.
authors.forename: Peter V
authors.initials: PV
authors.lastname: Giannoudis
mesh_terms: D000900:Anti-Bacterial Agents / Q000008:administration & dosage*; D001458:Bandages; D004202:Disinfectants; D016267:External Fixators / Q000009:adverse effects* / Q000382:microbiology; D005592:Fracture Fixation / Q000009:adverse effects / Q000295:instrumentation / Q000379:methods*; D050723:Fractures, Bone / Q000473:pathology / Q000601:surgery*; D006801:Humans; D015994:Incidence; D013530:Surgical Wound Infection / Q000209:etiology* / Q000382:microbiology / Q000517:prevention & control*; D007507:Therapeutic Irrigation / Q000379:methods; D016896:Treatment Outcome
chemical_list: D000900:Anti-Bacterial Agents; D004202:Disinfectants
keywords: Ilizarov ring fixator; Pin-site care; Pin-site infection rate