Which pin site dressing is the most optimal? A systematic review on current evidence
Background: Pin site infection is a frequent complication after external fixation. However, no consensus on the optimal pin site care protocols exists. Objectives: This study aimed at providing an overview of currently applied pin site care protocols and evaluating their efficiency in terms of infec...
| Main Authors: | , , , |
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| Format: | Article |
| Language: | English |
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Wolters Kluwer Medknow Publications
2022-01-01
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| Series: | Journal of Limb Lengthening & Reconstruction |
| Subjects: | |
| Online Access: | http://www.jlimblengthrecon.org/article.asp?issn=2455-3719;year=2022;volume=8;issue=3;spage=36;epage=43;aulast=Walter |
| _version_ | 1811180191205031936 |
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| author | Nike Walter Markus Rupp Ulrik Kähler Olesen Volker Alt |
| author_facet | Nike Walter Markus Rupp Ulrik Kähler Olesen Volker Alt |
| author_sort | Nike Walter |
| collection | DOAJ |
| description | Background: Pin site infection is a frequent complication after external fixation. However, no consensus on the optimal pin site care protocols exists. Objectives: This study aimed at providing an overview of currently applied pin site care protocols and evaluating their efficiency in terms of infection rates. Data Sources: A systematic search of PubMed, Medline, Embase, and Cochrane Library databases was performed. Study eligibility criteria, participants, and interventions: Comparative studies of pin site care protocols reporting the infection rate as complication related to external fixator application as an outcome were eligible for inclusion. Study Appraisal and Synthesis Methods: The ROBINS-I tool was used to assess the risk of bias in nonrandomized studies. The Effective Public Health Practice Project (EPHPP) tool and Coleman Methodology Score were applied for publication quality assessment. Results: A total of 380 manuscripts were screened, yielding an inclusion of 20 articles reporting on 1428 patients. Of these, 17 (85%) studies compared different materials and antimicrobial agents, whereby 9 of these found significant differences. Three studies compared pin site care with no pin site care, and the optimal pin site care frequency was addressed in three studies. None of them reported a statistically significant difference between daily or weekly pin site care. Limitations: Pin site care protocols in the literature are heterogeneous. Conclusions and Implications of Key Findings: No recommendation can be drawn regarding the optimal cleansing solution and dressing type. However, based on this review, a benefit of pin site care compared to no pin site care is suggested. Further, minimal pin care was not associated with significantly worse outcomes, and hence, the need of laborious protocols including frequent cleaning or the use of antimicrobial agents remains questionable. |
| first_indexed | 2024-04-11T06:46:04Z |
| format | Article |
| id | doaj.art-9d7f1b817e91498aab29ee62861678b8 |
| institution | Directory Open Access Journal |
| issn | 2455-3719 |
| language | English |
| last_indexed | 2024-04-11T06:46:04Z |
| publishDate | 2022-01-01 |
| publisher | Wolters Kluwer Medknow Publications |
| record_format | Article |
| series | Journal of Limb Lengthening & Reconstruction |
| spelling | doaj.art-9d7f1b817e91498aab29ee62861678b82022-12-22T04:39:20ZengWolters Kluwer Medknow PublicationsJournal of Limb Lengthening & Reconstruction2455-37192022-01-0183364310.4103/jllr.jllr_29_21Which pin site dressing is the most optimal? A systematic review on current evidenceNike WalterMarkus RuppUlrik Kähler OlesenVolker AltBackground: Pin site infection is a frequent complication after external fixation. However, no consensus on the optimal pin site care protocols exists. Objectives: This study aimed at providing an overview of currently applied pin site care protocols and evaluating their efficiency in terms of infection rates. Data Sources: A systematic search of PubMed, Medline, Embase, and Cochrane Library databases was performed. Study eligibility criteria, participants, and interventions: Comparative studies of pin site care protocols reporting the infection rate as complication related to external fixator application as an outcome were eligible for inclusion. Study Appraisal and Synthesis Methods: The ROBINS-I tool was used to assess the risk of bias in nonrandomized studies. The Effective Public Health Practice Project (EPHPP) tool and Coleman Methodology Score were applied for publication quality assessment. Results: A total of 380 manuscripts were screened, yielding an inclusion of 20 articles reporting on 1428 patients. Of these, 17 (85%) studies compared different materials and antimicrobial agents, whereby 9 of these found significant differences. Three studies compared pin site care with no pin site care, and the optimal pin site care frequency was addressed in three studies. None of them reported a statistically significant difference between daily or weekly pin site care. Limitations: Pin site care protocols in the literature are heterogeneous. Conclusions and Implications of Key Findings: No recommendation can be drawn regarding the optimal cleansing solution and dressing type. However, based on this review, a benefit of pin site care compared to no pin site care is suggested. Further, minimal pin care was not associated with significantly worse outcomes, and hence, the need of laborious protocols including frequent cleaning or the use of antimicrobial agents remains questionable.http://www.jlimblengthrecon.org/article.asp?issn=2455-3719;year=2022;volume=8;issue=3;spage=36;epage=43;aulast=Walterpin site carepin site dressingpin site infection |
| spellingShingle | Nike Walter Markus Rupp Ulrik Kähler Olesen Volker Alt Which pin site dressing is the most optimal? A systematic review on current evidence Journal of Limb Lengthening & Reconstruction pin site care pin site dressing pin site infection |
| title | Which pin site dressing is the most optimal? A systematic review on current evidence |
| title_full | Which pin site dressing is the most optimal? A systematic review on current evidence |
| title_fullStr | Which pin site dressing is the most optimal? A systematic review on current evidence |
| title_full_unstemmed | Which pin site dressing is the most optimal? A systematic review on current evidence |
| title_short | Which pin site dressing is the most optimal? A systematic review on current evidence |
| title_sort | which pin site dressing is the most optimal a systematic review on current evidence |
| topic | pin site care pin site dressing pin site infection |
| url | http://www.jlimblengthrecon.org/article.asp?issn=2455-3719;year=2022;volume=8;issue=3;spage=36;epage=43;aulast=Walter |
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