Primary Closure of External Fixator Pin Sites Is Safe After Orthopaedic Trauma Surgery

Area of Science:

• Orthopedic Surgery
• Infectious Disease Management

Background:

• External fixators are crucial for managing lower extremity fractures.
• Pin site care is critical to prevent infections after external fixator removal.
• Traditionally, external fixator pin sites are left to heal by secondary intention.

Purpose of the Study:

• To compare pin site infection and surgical site infection rates between primary closure and secondary healing of external fixator pin sites.
• To evaluate the safety and efficacy of primary closure for external fixator pin sites.

Main Methods:

• Retrospective cohort study.
• Inclusion of patients with lower extremity external fixators managed with primary closure or secondary healing.
• Comparison of infection rates between the two management groups.

Main Results:

• No significant difference in pin tract infection rates between primary closure (0.5%) and secondary healing (1.5%).
• A significantly lower rate of surgical site infections was observed in the primary closure group (7.7% vs. 15.9%).
• External fixator duration was similar between groups.

Conclusions:

• Primary closure of external fixator pin sites is a safe alternative to secondary healing.
• Primary closure may reduce the risk of surgical site infections.
• These findings suggest a shift from the dogma of secondary closure for external fixator pin sites.