Pin site care for preventing infections associated with external bone fixators and pins

Postoperative complications associated with external skeletal fixators in cats

“…In people, PTIs remain a significant issue and numerous postoperative strategies of pin site care have been proposed. 22 However, a recent meta-analysis on pin site care showed insufficient evidence to identify a strategy of pin site care that minimises infection rates. 22 Adequately powered randomised trials are required to examine the effects of different pin care regimens prior to making further recommendations.…”

“…22 However, a recent meta-analysis on pin site care showed insufficient evidence to identify a strategy of pin site care that minimises infection rates. 22 Adequately powered randomised trials are required to examine the effects of different pin care regimens prior to making further recommendations. 22 Other risk factors for small animal surgical site infection included gender, increased bodyweight and duration of anaesthesia.…”

Evidence-based decisions for local and systemic wound care

“…Nevertheless, modern caregivers are compelled to offer their patients best available care with proven effectiveness. The medical profession is changing rapidly, and all too often new evidence emerges that contradicts standard routines; yet it can take a considerable time to be implemented and 20,29 Apply local honey for quick healing, as WMD of 5 (−5.1, −4.3) days is reported compared with conventional dressings In acute wounds do not use silver sulfadiazine as topical agent; NNH 13 (7,1667) Laceration and soft tissue wounds 17 When in need of cleansing, use tap water of drinking quality rather than sterile saline solutions; NNT 3 (3, 7) Chronic wounds Venous ulcers 30,36,39 Systemic treatment with pentoxifylline increases complete wound healing; NNT 4 (3, 7) Use compression therapy for wound healing, adding high compression; multicomponent systems or elastic bandages are the most effective Diabetic ulcers 41,43 Use hyperbaric oxygen therapy to decrease major amputation rate; NNT 5 (3,12) Use local hydrogels to promote complete wound healing; NNT 5 (3, 10) Arterial ulcers in patients with critical leg ischaemia 49,50 Use systemic prostanoids in patients with critical leg ischaemia to relieve rest pain, NNT 11 (7,28), and improve ulcer healing, NNT 9 (6, 17) Use spinal cord stimulation to improve limb salvage; NNT 9 (5, 45) Pressure ulcers 51,56 Use high-specification foam mattresses, NNT 13 (10,21), and low air-loss mattresses, NNT 5 (3,9), to prevent pressure ulcers on the ward, and pressure-relieving overlays on the operating for the old routine to be abolished 63 . Some treatment practices, for which strong evidence is lacking, may still be warranted by other, lower levels of evidence not presented here.…”

Lower limb reconstruction

“…50 Pins placed through a muscular compartment such as the anterior compartment are at risk of pin site infection, because of the adjacent mobile soft tissues. A recent Cochrane review did not reach any definitive recommendations regarding pin site care.…”