Abstract. Introduction: Pin site infection is a common complication to external ring
fixation. While the aetiology is well described, monitoring of onset,
location, and the distribution of infection among the pin sites still needs
further attention. The present pilot study evaluates the feasibility of a
prospective registration procedure for reporting, evaluating, and monitoring
of pin site infections in patients treated with external ring fixation. This
may promote communication between team members and assist decision-making
regarding treatment.
Methods: A total of 39 trauma, limb deformity, and bone infection patients (15 female,
24 males; mean age 49 years (range: 12–88)) treated with external ring
fixation were followed in the outpatient clinic using the pin site
registration tool. Pin site infection (Checketts and Otterburn (CO) grade,
onset, location), use of oral or intravenous antibiotics, and any unplanned
procedures due to pin sites complications (wire removal and/or replacement,
premature frame removal, amputation, etc.) were registered until frame
removal.
Results: The mean (SD) frame time was 164 (83) d (range: 44–499). We
performed 3296 observations of 568 pin sites. Pin infection was registered
in 171 of the 568 pin sites (30 %), of which 112 (65 %) were categorized
as CO 1, 42 (25 %) as CO 2, 9 (5 %) as CO 3, and 8 (5 %) as CO 5. Neither CO 4 nor
CO 6 was observed. A total of 35 patients (90 %) encountered CO 1–3 at least once
during the observation time, while 1 patient (2.5 %) developed a major
infection at eight pin sites (CO 5). Antibiotics were administered to 22/39
(56 %) of the patients.
Conclusion: In an effort to monitor pin site infections in this complex
patient group and to ensure the best clinical outcomes, our registration
procedure in the outpatient clinic helped to recognize pin site infections
early and eased communication between team members providing a concise
overview of the treatment course.