Pin Tract Infection Following Correction of Charcot Foot With Static Circular Fixation

Abstract

Level IV, retrospective case series.

Novel Use of Active Leptospermum Honey for Ringed Fixator Pin Site Care in Diabetic Charcot Deformity Patients

“…The study by Finkler et al 2 on pin tract infection in Charcot foot offers the best option for comparison with our present study. In their series, as in ours, erythema and drainage resolved in all patients with local pin care and empiric oral antibiotic therapy.…”

“…Additionally, while some studies suggest that some patient factors such as HgA1c and osteomyelitis may correlate with increased rates of pin site infection, there do not appear to be clear predictors of infection in the management of this disease process, making risk stratification difficult. 2,32 In this prospective case series, we demonstrate the safety and efficacy of ALH-impregnated dressings when used for fine wire ringed fixator pin site care in diabetic Charcot deformity patients, with significantly reduced rates of pin site infection when compared with a retrospective control group.…”

“…Keywords: osteomyelitis; arthritis and joint disease; diabetes; wound care P in site infections are a welldocumented complication of external fixation with infection rates of up to 40%. [1][2][3][4][5][6] In the past decade, open reduction with external fixation (OREF) for correction of deformity in diabetic patients with Charcot deformity of the foot and/or ankle has gained popularity. Finkler et al 2 demonstrated a 20.8% pin site infection rate in a large, prospectively collected series of 283 diabetic patients undergoing single-stage correction of Charcot foot deformity with static fine-wire circular external fixation and a minimalist pin care protocol.…”

“…1-6 In the past decade, open reduction with external fixation (OREF) for correction of deformity in diabetic patients with Charcot deformity of the foot and/or ankle has gained popularity. Finkler et al 2 demonstrated a 20.8% pin site infection rate in a large, prospectively collected series of 283 diabetic patients undergoing single-stage correction of Charcot foot deformity with static fine-wire circular external fixation and a minimalist pin care protocol. In their series, there was no correlation identified between body mass index or osteomyelitis and pin site infection, though there was a statistically significant correlation between patients with elevated hemoglobin A1c levels and pin site infections.…”

Clinical Outcomes and Complications of Midfoot Charcot Reconstruction With Intramedullary Beaming

“…Although patients with a hemoglobin A 1c higher than 7% have been shown to be at increased risk for postoperative infection following internal fixation, similar patients have been shown to develop pin site infections at a higher rate when placed into external fixation. 5,10 Care should be taken to optimize patients’ diabetic control preoperatively, if possible, during the preoperative window for both techniques.…”