Caring for an External Fixator
How do I care for my pin sites?
Much like newly pierced ears must be allowed to heal, skin surrounding external fixation pins also be allowed to heal. Local wound care to all pin sites is of the utmost importance. Although atraumatic technique when inserting pins in the operating room is paramount, the challenge does not end there. Caring for your frame at home is a job that will be required until the frame is removed. To date, there is no universally accepted protocol for skin care around pin sites. Always follow your doctor's instructions when caring for your frame. This will typically include cleansing the pin sites and applying a dressing of some sort. Whether or not you are able to bear weight on your frame, you skin can become irritated, leading to infection and complications, if not cared for properly and diligently. |
What is a pin site infection?
Pin site infections typically begin as cellulitis around a pin. Cellulitis presents as an area of skin that is warm, red, and may have drainage associated. Cellulitis can quickly progress to a more severe form of infection. Frame loosening can be a contributor to infection development as well as a side effect of infection development. A secure, stable frame remains a key indicator for successful healing.
Please see the Checketts–Otterburn classification chart below for information on infection severity and treatment recommendations.
What do I do if I think I have a pin site infection?
If you believe that you are developing or have developed a pin site infection, it is important that you contact your surgeon right away. If you are unable to be seen by your surgeon in a timely fashion, you may also seek care at the Emergency Room if you feel that the infection is severe enough to warrant an emergent visit. Although approximately 75% of pin site infections are minor infections, a severe infection can quickly lead to more serious complications. Do not delay treatment for an infection of any type.
Ferreira N, Marais LC (2012) Prevention and management of external fixator pin track sepsis. Strateg Trauma Limb Reconstr 7(2):67–72. PubMed PMID: 22729940. Pubmed Central PMCID: 3535127
Pin site infections typically begin as cellulitis around a pin. Cellulitis presents as an area of skin that is warm, red, and may have drainage associated. Cellulitis can quickly progress to a more severe form of infection. Frame loosening can be a contributor to infection development as well as a side effect of infection development. A secure, stable frame remains a key indicator for successful healing.
Please see the Checketts–Otterburn classification chart below for information on infection severity and treatment recommendations.
What do I do if I think I have a pin site infection?
If you believe that you are developing or have developed a pin site infection, it is important that you contact your surgeon right away. If you are unable to be seen by your surgeon in a timely fashion, you may also seek care at the Emergency Room if you feel that the infection is severe enough to warrant an emergent visit. Although approximately 75% of pin site infections are minor infections, a severe infection can quickly lead to more serious complications. Do not delay treatment for an infection of any type.
Ferreira N, Marais LC (2012) Prevention and management of external fixator pin track sepsis. Strateg Trauma Limb Reconstr 7(2):67–72. PubMed PMID: 22729940. Pubmed Central PMCID: 3535127