Randomized Prospective Study on the Use of Eufiss in the Prevention of Infections in Patients Treated with External Fixation

Abstract

Percutaneous synthesis using K-wires or external fixation in orthopedics and traumatology is extremely common. Postoperative management of external fixation includes frequent wound care which is demanding for both the patient and the healthcare professionals. In literature the most frequently reported complication is infection. The use of ionic silver goes back to the beginning of the last century and there are many articles describing its antimicrobial efficacy even for antibiotic-resistant bacteria. In this study we assess the reduction in both superficial and deep infections by using ionic silver in patients with external fixation for orthopedic diseases or traumatology. Furthermore, we show how this method could also contribute to reducing wound care costs. The data collected shows an overall infection incidence of 10%, concordant with data in literature. There appears to be no correlation between the probability of superficial infections and predisposing diseases, such as diabetes, nor the fracture site or position. The presence of loose pins increases the probability of infection. There appears to be no correlation between the clinical examination and the microbiological culture. The data analysis shows that wound care with ionic silver reduces the incidence of superficial infection of the pins. Furthermore, this method guarantees greater cleanliness of the skin and the external fixator which increases patient satisfaction in the management of the external fixation. To date, an insufficient number of patients have been studied to gather enough data to establish which wound care method is the most economical. Certainly, we can state that treatment with ionic silver reduces infection incidence and enables better management of the external fixators and percutaneous synthesis in orthopedics and traumatology.

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