Strategies in Trauma and Limb Reconstruction

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VOLUME 17 , ISSUE 2 ( May-August, 2022 ) > List of Articles


Pin-site Infection: A Systematic Review of Prevention Strategies

David W Shields, Alexis-Dimitris Iliadis, Erin Kelly, Nima Heidari, Bilal Jamal

Keywords : Classification, Diagnosis, External fixation, Management, Pin-site infection, Prevention, Systematic review

Citation Information : Shields DW, Iliadis A, Kelly E, Heidari N, Jamal B. Pin-site Infection: A Systematic Review of Prevention Strategies. 2022; 17 (2):93-104.

DOI: 10.5005/jp-journals-10080-1562

License: CC BY-NC-SA 4.0

Published Online: 28-07-2022

Copyright Statement:  Copyright © 2022; The Author(s).


Introduction: Circular frame fixation remains a key tool in the armamentarium of the limb reconstruction surgeon. One of the key drawbacks is the onset of pin-site infection (PSI). As a result of limited evidence and consensus of PSI prevention, a wide variation in practice remains. Aim: The principal aim of this review is to synthesise primary research concerning all aspects of treatment regarded as relevant to PSI in frame constructs. Materials and methods: Comparative studies until week 26, 2021, were included in the trial. Studies were included that concerned patients undergoing management of a musculoskeletal condition in which pin-site care is necessary for over 4 weeks. Results: Eighteen studies over a 13-year period were captured using the search strategy. Sulphadiazine and hydrogen peroxide cleansing was found to reduce PSI, with the use of low-energy fine wires and hydroxyapatite (HA)-coated pins also associated with lower infection rate. The remainder of studies found no significant improvement across interventions. Conclusion: There is no superiority between weekly and daily care. Low-energy pin-insertion technique had lower rates of infection. Sulphadiazine has positive results as a pin-care solution, but more research is necessary to determine the most effective care regime. Current literature is limited by absence of established definitions and by a lack of studies addressing all aspects of care relevant to PSI.

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