Prevention of pin track infection in external fixation with silver coated pins: Clinical and microbiological results

Pin tract infection is a frequent complication of external fixation; accord ing to literature its frequency ranges from 2-30%. The recent introduction of silver coating of polymeric materials was found to decrease bacterial ad hesion; its clinical use with Foley catheters and central venous catheters led to significant results. To verify the ability of the same silver coatin g to decrease the bacterial colonization on external fixation screws, a pro spective randomized study was carried out on 24 male patients; a total of 1 06 screws were implanted in the lower limb to fix femoral or tibial diaphys eal fractures: 50 were coated with silver and 56 were commercially availabl e stainless steel screws. Although the coated screws resulted in a lower ra te of positive cultures (30.0%) than the uncoated screws (42.9%), this diff erence was not statistically significant (p = 0.243). the clinical behavior of the coated screws did not differ from that of the uncoated ones. Furthe rmore, the implant of silver-coated screws resulted in a significant increa se in the silver serum level, These results led us to consider it ethically unacceptable to continue this investigation. (C) 2000 John Wiley & Sons. I nc.