Efficacy of 1 % silver sulphadiazine dressings in preventing infection of external fixation pin-tracks: a randomized study

Pin-track infection (PTI) is a common complication of external fixation. Antimicrobial dressings of the pin-site interface should reduce the severity and incidence of PTI. This study is aimed at determining the efficacy of 1 % silver sulphadiazine dressings in preventing PTI in external fixation. We compared the incidence of PTI between group A (dry sterile gauze dressing) and group B (1 % silver sulphadiazine impregnated gauze dressing). PTI was diagnosed when there was: (1) redness around any pin-site, (2) tenderness near a pin-site and (3) serous or purulent discharge from the pin-skin interface. With infection, swab was obtained for microscopy, culture and sensitivity. Pin-track infections were diagnosed in 22.5 and 4.1 % of patients in groups A and B, respectively. This difference was statistically significant. The commonest organism isolated from swabs was Staphyloccus aureus. In patients with external fixation, 1 % silver sulphadiazine lowered PTI. This further underlines the need for antimicrobial dressings of pin-sites. We recommend the use of 1 % silver sulphadiazine impregnated ribbon gauze for pin-site dressings. Level of evidence II.