Prevention and Management of External Fixator Pin Track Sepsis

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Strat Traum Limb Recon (2012) 7:67–72 DOI 10.1007/s11751-012-0139-2 REVIEW Prevention and management of external fixator pin track sepsis Nando Ferreira • Leonard Charles Marais Received: 19 June 2011 / Accepted: 5 June 2012 / Published online: 23 June 2012 Ó The Author(s) 2012. This article is published with open access at Springerlink.com Abstract Pin track-associated complications are almost universal findings with the use of external fixation. These complications are catastrophic if it leads to the failure of the bone–pin interface and could lead to pin loosening, fracture non-union and chronic osteomyelitis. Strategies proposed for the prevention and management of pin track complications are diverse and constantly changing. Prevention of external fixation pin track infection is a complex and ongoing task that requires attention to detail, meticulous surgical technique and constant vigilance. Keywords fixation Pin site Á Infection Á Complications Á External Background Pin track infection is almost inevitable during the longterm use of external fixators with the quoted incidence ranging from 11.3 to 100 % [3–11]. Bibbo [2] stated that ‘Pin-site irritation/infection have almost become an accepted certainty in the realm of external fixation, with physicians relying heavily on the majority of those complications resolving without consequences by using appropriate pin care and antibiotic therapy’. Fixator pin–bone interface stability Pin track infection decreases the stability of the pin–bone interface. Conversely, instability of the fixator pin–bone construct can lead to half-pin loosening and infection [3]. It is a common misconception that pin loosening only results from pin track infection when in actual fact pin loosening is often the initiating event resulting in pin track sepsis. In the light of this, the external fixator construct is crucial in the

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