From prevention of pin-tract infection to treatment of osteomyelitis during paediatric external fixation

Abstract

Pin-tract infection (PTI) is the most commonly expected problem, or even an almost inevitable complication, when using external fixation. Left unteated, PTI will progress unavoidably, lead to mechanical pin loosening, and ultimately cause instability of the external fixator pin–bone construct. Thus, PTI remains a clinical challenge, specifically in cases of limb lengthening or deformity correction. Standardised pin site protocols which encompass an understanding of external fixator biomechanics and meticulous surgical technique during pin and wire insertion, postoperative pin site care and pin removal could limit the incidence of major infections and treatment failures. Here we discuss concepts regarding the epidemiology, physiopathology and microbiology of PTI in paediatric populations, as well as the clinical presentations, diagnosis, classification and treatment of these infections.

Epidemiology, microbiology and therapeutic consequences of chronic osteomyelitis in northern China: A retrospective analysis of 255 Patients

“…The remaining three of the most five common bacteria were all g- bacteria. This is similar to most results found in clinical reports in China and abroad 8 , 9 , 19 – 21 .…”

Current data on extremities chronic osteomyelitis in southwest China: epidemiology, microbiology and therapeutic consequences

“…Staphylococcus aureus is abundant in the skin microflora and in mucus and is a frequent cause of biofilm-associated infections 17 , 18 . A study by Arias 4 examined 193 patients with S .…”

Reduction of bacterial adhesion on titanium-doped diamond-like carbon coatings

“…The high incidence of infections caused by the use of metallic biomedical implants and devices, including bone fracture fixation pins and hip and knee replacement, has a severe impact on human health and health care costs (Bociaga et al 2015;Percival et al 2015;Ceroni et al 2016;Dunne et al 2017). Prevention of bacterial adhesion on the surfaces of medical devices will have a major impact in preventing medical device-related infections.…”