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Debridement Versus Simple Scrubbing of External Fixator Pin Sites

INTRODUCTION: Irrigation and debridement of external fixator pin sites are methods utilized by some orthopedic surgeons to minimize the risk of surgical site infections in patients undergoing definitive internal fixation after temporization in an external fixation device. This study aimed to determi...

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Autores principales: Nolte, Jack, Dallman, Johnathan, Tucker, William, Christensen, Erin, Heddings, Archie
Formato: Online Artículo Texto
Lenguaje:English
Publicado: University of Kansas Medical Center 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9612902/
https://www.ncbi.nlm.nih.gov/pubmed/36320336
http://dx.doi.org/10.17161/kjm.vol15.18219
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author Nolte, Jack
Dallman, Johnathan
Tucker, William
Christensen, Erin
Heddings, Archie
author_facet Nolte, Jack
Dallman, Johnathan
Tucker, William
Christensen, Erin
Heddings, Archie
author_sort Nolte, Jack
collection PubMed
description INTRODUCTION: Irrigation and debridement of external fixator pin sites are methods utilized by some orthopedic surgeons to minimize the risk of surgical site infections in patients undergoing definitive internal fixation after temporization in an external fixation device. This study aimed to determine if irrigation and debridement of external fixator pin sites leads to fewer deep surgical site infections, compared to simply scrubbing the external fixator pin sites with a chlorhexidine scrub-brush. METHODS: This single center retrospective cohort study was performed at a university level I trauma center. All cases in which a single surgeon removed an external fixator and followed this with definitive open reduction and internal fixation (ORIF) in the same operative setting between October 2007 and October 2018 were reviewed. A total of 313 patients were temporized in 334 external fixators prior to ORIF and were included in the study. RESULTS: Eighteen of the 179 Irrigation and Debridement cohort (10.0%) and 8 of the 155 Simple Scrubbing cohort (5.2%) had infections that required a return to the operating room. No statistical difference (p = 0.10) or meaningful effect size (Cohen’s d = 0.18) were found between irrigation and debridement and simple scrubbing of external fixator pin sites. CONCLUSIONS: Given no significant differences were found in deep infection rates between debridement of pin sites versus simply scrubbing, it is reasonable to ask whether the time and resources required for debriding external fixator pin sites is worthwhile.
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spelling pubmed-96129022022-10-31 Debridement Versus Simple Scrubbing of External Fixator Pin Sites Nolte, Jack Dallman, Johnathan Tucker, William Christensen, Erin Heddings, Archie Kans J Med Original Research INTRODUCTION: Irrigation and debridement of external fixator pin sites are methods utilized by some orthopedic surgeons to minimize the risk of surgical site infections in patients undergoing definitive internal fixation after temporization in an external fixation device. This study aimed to determine if irrigation and debridement of external fixator pin sites leads to fewer deep surgical site infections, compared to simply scrubbing the external fixator pin sites with a chlorhexidine scrub-brush. METHODS: This single center retrospective cohort study was performed at a university level I trauma center. All cases in which a single surgeon removed an external fixator and followed this with definitive open reduction and internal fixation (ORIF) in the same operative setting between October 2007 and October 2018 were reviewed. A total of 313 patients were temporized in 334 external fixators prior to ORIF and were included in the study. RESULTS: Eighteen of the 179 Irrigation and Debridement cohort (10.0%) and 8 of the 155 Simple Scrubbing cohort (5.2%) had infections that required a return to the operating room. No statistical difference (p = 0.10) or meaningful effect size (Cohen’s d = 0.18) were found between irrigation and debridement and simple scrubbing of external fixator pin sites. CONCLUSIONS: Given no significant differences were found in deep infection rates between debridement of pin sites versus simply scrubbing, it is reasonable to ask whether the time and resources required for debriding external fixator pin sites is worthwhile. University of Kansas Medical Center 2022-10-24 /pmc/articles/PMC9612902/ /pubmed/36320336 http://dx.doi.org/10.17161/kjm.vol15.18219 Text en © 2022 The University of Kansas Medical Center https://creativecommons.org/licenses/by-nc-nd/4.0/This is an open-access article distributed under the terms of the Creative Commons Attribution Non-Commercial No Derivatives (by-nc-nd) License. (CC-BY-NC-ND 4.0: https://creativecommons.org/licenses/by-nc-nd/4.0/)
spellingShingle Original Research
Nolte, Jack
Dallman, Johnathan
Tucker, William
Christensen, Erin
Heddings, Archie
Debridement Versus Simple Scrubbing of External Fixator Pin Sites
title Debridement Versus Simple Scrubbing of External Fixator Pin Sites
title_full Debridement Versus Simple Scrubbing of External Fixator Pin Sites
title_fullStr Debridement Versus Simple Scrubbing of External Fixator Pin Sites
title_full_unstemmed Debridement Versus Simple Scrubbing of External Fixator Pin Sites
title_short Debridement Versus Simple Scrubbing of External Fixator Pin Sites
title_sort debridement versus simple scrubbing of external fixator pin sites
topic Original Research
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9612902/
https://www.ncbi.nlm.nih.gov/pubmed/36320336
http://dx.doi.org/10.17161/kjm.vol15.18219
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