Table 4.
Pin-site dressings
| Author | Interventions | No. of patients | No. of pin sites | Patient population | Pin-care regimes | Findings |
|---|---|---|---|---|---|---|
| Chan, 20098 | Diluted betadine dressings | 30 | ND | Adults and children undergoing distraction osteogenesis using fine wires and half pins | ND | Overall infection rate 18% 19% PSI with betadine dressings, 17% with saline (NS) |
| Saline dressings | 30 | ND | ||||
| Yuenyongviwat, 20099 | 0.5% sulphadiazine (n = 15) |
15 | ND | Open fractures definitively managed with external fixators | Daily saline then sulphadiazine dressing from day 3 | 43.7% PSI with sulphadiazine dressings 40% dry dressings (NS) |
| Dry dressing (n = 15) | 15 | ND | Daily dry dressing (with optional crust removal) from day 3 | |||
| Ogbemudia, 201010 | Chlorhexidine dressing | 38 | ND | Patients aged 5–75 requiring external fixation | Experimental dressing for 72 hours then reapplied and changed weekly 5 days of postoperative antibiotics |
23.7% PSI with chlorhexidine alone 7.9% PSI with chlorhexidine and sulphadiazine Statistically significant p = 0.03 |
| 5% chlorhexidine and 1% sulphadiazine | 38 | ND | ||||
| Lee, 201211 | Polyhexamethylene biguanide (PHMB) gauze | 22 | 216 | Patients undergoing limb lengthening/deformity correction using external fixation | Daily dressings | Overall infection rate 2.6% 1% PSI with PHMB dressings 4.5% PSI with plain gauze dressings p = 0.00 |
| Plain gauze | 18 | 267 | ||||
| Subramanyam, 201918 | 10% povidone iodine* | 27 | 561 | All patients without infection undergoing fine-wire constructs | Once weekly or once daily (substratified) | 44% patients developed PSI with 37% patients developed PSI with silver sulphadiazine dressings 40% patients developed PSI with chlorhexidine dressings 33% patients PSI with plain gauze dressings (NS) |
| 1% silver sulphadiazine | 27 | 570 | ||||
| 1% chlorhexidine | 30 | 594 | ||||
| No solution | 30 | 638 | ||||
| Patterson, 200514 | 3% bismuth tribromophenate and petroleum gauze (Xeroform) | 42 | 192 | Consecutive adults and children treated for factures | Twice daily dressing changes (with exception of 1 subgroup with change as required). Cleansing subgroups as per Table 3 | 14% PSI in patients with Xeroform dressings (across H2O2, saline and soap pin cleaners) 25% PSI in patients with plain gauze dressings (across H2O2, saline and soap pin cleaners and no cleaning solution) No statistical comparison declared |
| Plain gauze | 50 | 235 | ||||
| Ferguson, 202120 | 0.5% chlorhexidine | 59 | ND | >16-year-old patients with tibial fractures treated with circular frame | Patient-led weekly dressings; Crust retained, chlorhexidine or Dermol pin dressing | 40% PSI in CHX group 44% PSI in DML group (NS) Thicker epidermis associated with PSI 7% pin-site reaction to chlorhexidine |
*Under plain gauze; CHX, chlorhexidine; DML, Dermol; ND, not declared; NS, not statistically significant