Related Experiment Video
Updated: Sep 11, 2025
Application of a New Mesh Fixation Method in Laparoscopic Incisional Hernia Repair
Published on: December 23, 2022
Primary Suture Closure of External Fixation Pin Sites After Removal Has a Lower Risk of Infection Compared With Pin
Molly Sekar1, Jackson Woodrow1, Lindsey Lamb2
1Department of Orthopaedic Surgery, University of Arizona College of Medicine, Phoenix, AZ.
Objectives:
To compare infection rates after external fixation removal, comparing pin sites that were primary closed with those left open to heal by secondary intention.
Design:
Retrospective review.
Setting:
Multicenter study.
Patient Selection Criteria:
All adult patients (18 years and older) who underwent removal of external fixator that was used for extremity fractures from 2007 to 2023 with at least 30 days follow-up. Patients were stratified into 2 cohorts: (1) external fixator pin sites primarily closed after external fixator removal and (2) pin sites left open to heal with secondary intention after external fixator removal.
Outcome Measures And Comparisons:
Patient characteristics, fracture characteristics, and details of the external fixator removal surgery were recorded. Comparison of the rate of surgical site infection (SSI) of pin site after external fixation removal were performed between the 2 groups (pin sites that were closed primarily and those left open after external fixator removal).
Results:
A total of 412 patients were included, with a mean follow-up of 259 days. There were 254 patients in the closed pin site after pin removal group (mean age 53 years, range 18-95, 39% female) and 158 in the pin sites left open after pin removal group (mean age 54 years, range 18-93, 49.4% female). The median duration of external fixator in the closed group was 11 days and 19 days in the open group ( P < 0.05). Multivariate analysis demonstrated increased odds of SSI of pin site after pin removal if the pin site was left open (odds ratio = 3.2; 95% confidence interval, 1.44-7.19, P < 0.01) and with tibial plateau fractures (odds ratio = 4.45; 95% confidence interval, 1.92-10.32, P < 0.001).
Conclusions:
After external fixation removal, closure of pin sites was associated with lower risk of pin site SSI after pin removal compared with leaving them open when external fixation duration was less than 2 weeks. External fixation is a common procedure, and this study can help change practice and decrease the risk of SSI of pin site after pin removal.
Level Of Evidence:
Therapeutic Level III. See Instructions for Authors for a complete description of levels of evidence.
More Related Videos
09:00Application of Straight-needle, Three-tailed, Knot-free, Peritoneal Sutures in Laparoscopic Transabdominal Preperitoneal Hernia Repair
Published on: November 12, 2021
08:20A Reliable and Reproducible Critical-Sized Segmental Femoral Defect Model in Rats Stabilized with a Custom External Fixator
Published on: March 24, 2019
Related Concept Videos
01:22Sutures of the Skull
Sutures are immobile joints between adjacent bones of the skull. The narrow gap between the bones is filled with dense, fibrous connective tissue that unites the bones. The long sutures located between the skull bones are not straight but instead follow irregular, tightly twisting paths. These twisting lines tightly...
01:27Fractures: Bone Repair
Minor fractures with no bone displacement are treated by immobilizing the fractured bone using a cast or splint. However, in the case of fractures with displaced bones, the broken bones are repositioned before immobilization to ensure successful healing without deformation and loss of function. The realignment of fractured bone ends is performed through a process called reduction. If the...