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Pin-site Infection: A Systematic Review of Prevention Strategies

INTRODUCTION: Circular frame fixation remains a key tool in the armamentarium of the limb reconstruction surgeon. One of the key drawbacks is the onset of pin-site infection (PSI). As a result of limited evidence and consensus of PSI prevention, a wide variation in practice remains. AIM: The princip...

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Autores principales: Shields, David W, Iliadis, Alexis-Dimitris, Kelly, Erin, Heidari, Nima, Jamal, Bilal
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Jaypee Brothers Medical Publishers 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9357789/
https://www.ncbi.nlm.nih.gov/pubmed/35990183
http://dx.doi.org/10.5005/jp-journals-10080-1562
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author Shields, David W
Iliadis, Alexis-Dimitris
Kelly, Erin
Heidari, Nima
Jamal, Bilal
author_facet Shields, David W
Iliadis, Alexis-Dimitris
Kelly, Erin
Heidari, Nima
Jamal, Bilal
author_sort Shields, David W
collection PubMed
description INTRODUCTION: Circular frame fixation remains a key tool in the armamentarium of the limb reconstruction surgeon. One of the key drawbacks is the onset of pin-site infection (PSI). As a result of limited evidence and consensus of PSI prevention, a wide variation in practice remains. AIM: The principal aim of this review is to synthesise primary research concerning all aspects of treatment regarded as relevant to PSI in frame constructs. MATERIALS AND METHODS: Comparative studies until week 26, 2021, were included in the trial. Studies were included that concerned patients undergoing management of a musculoskeletal condition in which pin-site care is necessary for over 4 weeks. RESULTS: Eighteen studies over a 13-year period were captured using the search strategy. Sulphadiazine and hydrogen peroxide cleansing was found to reduce PSI, with the use of low-energy fine wires and hydroxyapatite (HA)-coated pins also associated with lower infection rate. The remainder of studies found no significant improvement across interventions. CONCLUSION: There is no superiority between weekly and daily care. Low-energy pin-insertion technique had lower rates of infection. Sulphadiazine has positive results as a pin-care solution, but more research is necessary to determine the most effective care regime. Current literature is limited by absence of established definitions and by a lack of studies addressing all aspects of care relevant to PSI. HOW TO CITE THIS ARTICLE: Shields DW, Iliadis AD, Kelly E, et al. Pin-site Infection: A Systematic Review of Prevention Strategies. Strategies Trauma Limb Reconstr 2022;17(2):93–104.
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spelling pubmed-93577892022-08-18 Pin-site Infection: A Systematic Review of Prevention Strategies Shields, David W Iliadis, Alexis-Dimitris Kelly, Erin Heidari, Nima Jamal, Bilal Strategies Trauma Limb Reconstr Review Article INTRODUCTION: Circular frame fixation remains a key tool in the armamentarium of the limb reconstruction surgeon. One of the key drawbacks is the onset of pin-site infection (PSI). As a result of limited evidence and consensus of PSI prevention, a wide variation in practice remains. AIM: The principal aim of this review is to synthesise primary research concerning all aspects of treatment regarded as relevant to PSI in frame constructs. MATERIALS AND METHODS: Comparative studies until week 26, 2021, were included in the trial. Studies were included that concerned patients undergoing management of a musculoskeletal condition in which pin-site care is necessary for over 4 weeks. RESULTS: Eighteen studies over a 13-year period were captured using the search strategy. Sulphadiazine and hydrogen peroxide cleansing was found to reduce PSI, with the use of low-energy fine wires and hydroxyapatite (HA)-coated pins also associated with lower infection rate. The remainder of studies found no significant improvement across interventions. CONCLUSION: There is no superiority between weekly and daily care. Low-energy pin-insertion technique had lower rates of infection. Sulphadiazine has positive results as a pin-care solution, but more research is necessary to determine the most effective care regime. Current literature is limited by absence of established definitions and by a lack of studies addressing all aspects of care relevant to PSI. HOW TO CITE THIS ARTICLE: Shields DW, Iliadis AD, Kelly E, et al. Pin-site Infection: A Systematic Review of Prevention Strategies. Strategies Trauma Limb Reconstr 2022;17(2):93–104. Jaypee Brothers Medical Publishers 2022 /pmc/articles/PMC9357789/ /pubmed/35990183 http://dx.doi.org/10.5005/jp-journals-10080-1562 Text en Copyright © 2022; The Author(s). https://creativecommons.org/licenses/by-nc-sa/4.0/© The Author(s). 2022 Open Access This article is distributed under the terms of the Creative Commons Attribution-Non Commercial-share alike license (https://creativecommons.org/licenses/by-nc-sa/4.0/) which permits unrestricted distribution, and non-commercial reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. If you remix, transform, or build upon the material, you must distribute your contributions under the same license as original. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/ (https://creativecommons.org/publicdomain/zero/1.0/) ) applies to the data made available in this article, unless otherwise stated.
spellingShingle Review Article
Shields, David W
Iliadis, Alexis-Dimitris
Kelly, Erin
Heidari, Nima
Jamal, Bilal
Pin-site Infection: A Systematic Review of Prevention Strategies
title Pin-site Infection: A Systematic Review of Prevention Strategies
title_full Pin-site Infection: A Systematic Review of Prevention Strategies
title_fullStr Pin-site Infection: A Systematic Review of Prevention Strategies
title_full_unstemmed Pin-site Infection: A Systematic Review of Prevention Strategies
title_short Pin-site Infection: A Systematic Review of Prevention Strategies
title_sort pin-site infection: a systematic review of prevention strategies
topic Review Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9357789/
https://www.ncbi.nlm.nih.gov/pubmed/35990183
http://dx.doi.org/10.5005/jp-journals-10080-1562
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