Pin site care during external fixation in children: Results of a nihilistic approach

We prospectively followed 27 consecutive children with tibial circular exte rnal fixators applied between July 1, 1995, and June 30, 1997. A simple pin care system with no physical pin cleansing except that provided by daily s howers was used. Children with inflamed or infected pin sites were placed o n an oral antibiotic (cephalexin) for 10 days. Pin sites were graded accord ing to the system of Dahl et al. on a 0 to 5 scale. A total of 4,473 observ ations was made. Patients developed 178 pin tract infections (4.0% per obse rvation), with 151 (85%) grade 1 and 27 (15%) grade 2 infections. No pin wa s removed because of infection. Diaphyseal half pin sites were less commonl y infected (1.6%) than periarticular wire or half pin sites (4.5%). We reco mmend only showering without other physical pin cleaning procedures in chil dren undergoing external fixation procedures.