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Managing pin sites in primary care

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Figure 1. Irritated pin sites will usually resolve Figure 1. Irritated pin sites will usually resolve with rest and elevation and do not require antibiotics

External fixation has been widely used for many years in the UK, and is used for procedures such as fixation of complex fractures and realignment of limbs. Guidelines on management of open fractures advocate the use of external fixation.1

When a fracture is repaired with external fixation, the wires are visible outside the body. A pin site is a percutaneous wound where a wire or screw transfixes the skin and bone.

A pin site will never heal, due to the wire’s presence in the skin. Healing cannot begin until the external fixator is removed when the bone has healed. The main aim of wound care in these cases is to prevent infection from occurring.

Pin site infection is the most common local complication of external fixation, so many different care protocols have been used to try to minimise the risks of infection.

Pin site infections are usually acquired through healthcare intervention and should be considered as healthcare-associated infections.2 This, therefore, reflects the effectiveness and quality of pin site care provided by a healthcare organisation, as efficient care is crucial to prevent infections.

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I am caring for my 3 year old son. I am wondering if anybody can describe the pain of cleaning pin sites does it go after the initial sting and once the pain relief kicks in or does it last? I currently shower then clean all pin sites every evening then just clean any weeping pins or tenting pins in the morning if any but could this be affecting his already uncomfortable sleep doing it before bed should i swap it to morning?
Posted by: ,
I thank you so much for this article. Even though I am in the USA it was very informative.
I broke my wrist and had pins put in 2/9. I had noticed some crusting around a couple of the pins, but not drainage so I was trying to see if that was important. I had also noticed some hardness of the skin by another pin (I have 6 pins).
It has been hard to find information about the pins. There is a lot of information of what they are, but not so much about caring for the pins and the signs to look for.

Thank you.
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