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After-Care Instructions To Prevent Pin Tract Infections

PIN CARE:pin care

  • The pin sponges and dressing are removed, and pin care is initiated one week after surgery.
  • Daily pin-site care with a solution of one-half normal saline solution and one-half antimicrobial soap performed daily to each pin site in the skin.
  • Do not use hydrogen peroxide, as it could damage healthy tissue.
  • If dried crusts appear around the pin and skin, interface, leave in place and do not disturb, as chances for infection increase when the crusts are removed. The crust should only be removed when continuous drainage is present.
  • Treatment with the placement of chlorhexidine-impregnated discs (Biopatch) around the pins, with weekly changes of the discs by Dr. Thomajan may be performed if originally used at the time of surgery.
  • At two to three weeks, pin care continues during daily showers with antibacterial soap and thorough water rinse to the leg and the fixator. The fixator and leg are dried with a clean towel and hair dryer (cool setting).

COMMON COMPLICATIONS:

  • The most common problems encountered with ring fixation is a localized wire or pin site infection with a chance of mild pain.
  • It is important to inspect all pin sites daily to assess for signs of infection or loosening, including localized redness, pain and tenderness, warmth, swelling (firm or fluctuant), and drainage from the pin or wire that may vary in color and odor.
  • When early signs of pin site infection are noted, pin care is increased to twice daily, the pin is wrapped with a gauze roll, range of motion is discontinued and weight bearing and physical therapy are limited. Call Dr. Thomajan to discuss treatment or to schedule an appointment.
  • If symptoms of a pin site infection do not rapidly improve, oral antibiotics are prescribed. Pin site infections usually resolve in 24 hours of starting oral antibiotic treatment.
  • Recalcitrant pin site infections are treated with intravenous antibiotics, with or without pin removal. A special ring fixator cover made by Quantum Medical Concepts, may be necessary, and is worn when the patient is outside the house to limit potential contamination by environmental factors.
Dr. Craig H. Thomajan, DPM, FACFAS, FAENS
Founder and Managing Partner of Austin Foot and Ankle Specialists