Routine pin tract care in external fixation is unnecessary: a randomised, prospective, blinded controlled study

Area of Science:

• Orthopedics
• Infectious Disease Prevention

Background:

• Pin site infections are a common complication (up to 40%) of external fixator (ExFix) devices.
• Current literature lacks consensus on optimal pin tract care protocols for infection prevention.
• This study introduces the first intra-subject, randomized, prospective controlled trial on ExFix pin site care.

Purpose of the Study:

• To compare the efficacy of daily pin tract care versus no pin tract care in preventing complications associated with external fixators.
• To evaluate the impact of pin tract care on soft-tissue interface, pin stability, osteolysis, and pain.

Main Methods:

• A prospective, intra-subject, randomized controlled trial involving 56 patients (204 pins) at a national referral hospital.
• Pins were randomized to either daily pin site care (101 pins) or no treatment (103 pins).
• Outcomes including soft-tissue interface, pin stability, osteolysis, and pain were assessed blindly. Torque was measured to assess stability.

Main Results:

• No statistically significant differences were observed between the daily care and no care groups for any assessed outcome.
• Soft-tissue interface issues (granulation/secretion) were similar (36% vs. 35%).
• Pin loosening, osteolysis, and torque measurements showed no significant variations between groups.

Conclusions:

• Routine pin tract care is unnecessary for patients undergoing external fixation treatment.
• Simplifying pin site management protocols can potentially reduce patient burden without compromising treatment outcomes.