Pin-site care: can we reduce the incidence of infections?

Ktistakis, Ioannis; Guerado, Enrique; Giannoudis, Peter V.

doi:10.1016/s0020-1383(15)30009-7

Cited by 47 publications

(19 citation statements)

References 30 publications

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“…Although we observed only one superficial pin site infection in our series, pin site infections are common. Although definitions vary, rates of superficial pin site infections have been reported from 2%-100% [12] . However, these are generally easily treated with oral antibiotics.…”

Section: Discussionmentioning

confidence: 99%

External fixator immobilization after extensor mechanism reconstruction in total knee arthroplasty

2018

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Extensor mechanism disruption after total knee arthroplasty is a complicated problem that typically requires surgical reconstruction. After extensor mechanism failure, reconstruction is typically indicated to restore active knee extension and provide a stable limb for ambulation. Immobilization of the knee in extension is vital in the initial postoperative period after extensor mechanism reconstruction. We describe a series of 4 patients who underwent extensor mechanism reconstruction followed by external fixator application to maintain the knee extended in the initial postoperative period. Our results have been favorable. However, close follow-up is important to monitor for the development of pin site infections.

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Section: Discussionmentioning

confidence: 99%

External fixator immobilization after extensor mechanism reconstruction in total knee arthroplasty

2018

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“…Ktistakis et al . [ 12 ] noted that meticulous surgical technique is essential for preventing infection. For example, they recommended the use of a well-positioned skin incision, a non-touch technique for wire handling, advancement of the pin into the soft tissue by tapping rather than drilling, predrilling, and washing out bone debris before inserting half-pins.…”

Section: Discussionmentioning

confidence: 99%

Delayed methicillin-resistant Staphylococcus aureus-induced osteomyelitis of the tibia after pin tract infection: two case reports

et al. 2017

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BackgroundPin tract infection is a common complication of external fixation. It usually heals after treatment with debridement, antibiotics, and/or pin removal, only rarely developing into delayed osteomyelitis. We treated two patients with delayed methicillin-resistant Staphylococcus aureus-induced osteomyelitis of the tibia following pin tract infection.Case presentationOne patient, a diabetic 60-year-old Japanese man, underwent definitive external fixation using an Ilizarov fixator for postoperative osteomyelitis of an open fracture of his left ankle. One year after removing the external fixator, he developed methicillin-resistant Staphylococcus aureus-induced osteomyelitis of the tibial pin site. He underwent surgical debridement four times. No recurrence was seen 2 years 8 months after the last debridement. Another patient, a healthy 38-year-old Japanese man, underwent bilateral temporary external fixation for a right ankle open fracture and a comminuted fracture of the left tibial plateau. Three months after removal of the external fixator, he was diagnosed with methicillin-resistant Staphylococcus aureus-induced osteomyelitis of the bilateral tibial pin sites. He underwent surgical debridement three times, but the infection of his right tibia persisted. Finally, a gastrocnemius muscle flap was placed. No recurrence was seen 2 years after this last surgery.ConclusionsPin tract infection should not be considered a minor complication because osteomyelitis may develop, requiring treatment that is more aggressive than curettage of the pin tract. A gastrocnemius flap is a useful treatment option for refractory osteomyelitis because flap harvest causes less functional disturbance and is a relatively easy surgical technique.

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“…Pin tract infections are a common complication of half‐pins given their percutaneous nature . Changes in surgical techniques and postoperative care are still being tested to address this issue . In principle, an ideal scenario for half‐pins involves a setting with minimal to no motion at the skin‐pin interface, thus producing less local irritation, inflammation, and pain, and potentially less risk of infection.…”

Section: The Living Bone and The Endosteal‐implant Interfacementioning

confidence: 99%

Orthopaedic osseointegration: Implantology and future directions

Overmann

Aparicio

Richards

et al. 2020

Journal Orthopaedic Research

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Osseointegration (OI) is the direct anchorage of a metal implant into bone, allowing for the connection of an external prosthesis to the skeleton. Osseointegration was first discovered in the 1960s based on the microscopic analysis of titanium implant placed into host bone. New bone was observed to attach directly to the metal surface. Following clinical investigations into dentistry applications, OI was adapted to treat extremity amputations. These bone anchored implants, which penetrate the skin and soft tissues, eliminate many of the challenges of conventional prosthetic sockets, such as poor fit and suspension, skin breakdown, and pain. Osseointegrated implants show promise to improve prosthesis use, pain, and function for amputees. The successful process of transcutaneous metal integration into host bone requires three synergistic systems: the host bone, the metal implant, and the skin‐implant interface. All three systems must be optimized for successful incorporation and longevity of the implant. Osseointegration begins during surgical implantation of the metal components through a complex interplay of cellular mechanisms. While implants can vary in design—including the original screw, press fit implants, and compressive osseointegration—they face common challenges to successful integration and maintenance of fixation within the host bone. Overcoming these challenges requires the understanding of the complex interactions between each element of OI. This review outlines (a) the basic components of OI, (b) the science behind both the bone‐implant and the skin‐implant interfaces, (c) the current challenges of OI, and (d) future opportunities within the field.

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Pin-site care: can we reduce the incidence of infections?

Cited by 47 publications

References 30 publications

External fixator immobilization after extensor mechanism reconstruction in total knee arthroplasty

External fixator immobilization after extensor mechanism reconstruction in total knee arthroplasty

Delayed methicillin-resistant Staphylococcus aureus-induced osteomyelitis of the tibia after pin tract infection: two case reports

Orthopaedic osseointegration: Implantology and future directions

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