Pin site infection is common following the use of pins or wires in the treatment of orthopedic conditions. This can however be easily prevented by a method that can be used at home as we shall discuss below.
What is a pin site infection?
Pin site infection refers to the presence of any sign of infection on the skin where a metallic pin anchoring the bone passes.
These pins are commonly used in the treatment of broken or deformed bones. They are applied;
- For skeletal traction.
- As a temporary or definitive means of treatment for a bone pathology in an external fixator.
- For bone lengthening with an external fixator.
Important tips;
- Importantly wash your hands before you start the cleaning.
- Try not to be too aggressive while dressing as this can lead to bleeding.
Steps in cleaning of pin sites
1. Make sure that you have the necessary requirements. These include;
- A bottle of normal saline
- Sterile gauze
- Medical gloves (non-sterile gloves are sufficient)
All these items can be bought at a drug store /pharmacy without a prescription.
2. Using a needle make 2 holes at the top of the saline bottle. Squirt some saline at the site where the pin pierces the skin making sure the bottle never touches the pin or the skin.
Adequately dampen the skin and the gauze you are to use for cleaning the site.
If there is any crust at the pin site, let it soak out until it is soft enough then begin to clean it away with the gauze.
Use a different piece of gauze for each site.
After a thorough cleaning, dry the site with a new piece of gauze and dress that site with a dry one.
Do this daily for the first 1 week after discharge from the hospital and then progress to once weekly or as directed by your doctor.
There is controversy on the kind of solution to use for cleaning so don’t be surprised if your doctor recommends you clean your wounds with iodine solution or chlorhexidine solution.
These pin sites are expected to be dry by about 2 weeks following the discharge and then weekly dressing or dressing when required can be done just to keep the site clean.
Home-made alternative to normal saline.
In incidences where you really cannot get access to saline, then you can make your own at home. Be warned though that it can only be used for wound dressing and should never substitute for the intravenous solution administered in hospitals!
Preparation outline
- Measure out one liter (1lt) of water and one teaspoon of salt (1tsp).
- Add the water and salt to a clean pan.
- Place the water over heat to boil to 100 degrees.
- After it has boiled, take it off the heat and let it cool completely.
- Then move it to a clean container and start using it for the dressing procedures as required.
- Always keep this solution free of contamination.
When do you need to urgently see a doctor?
- Painful swelling of the limb. This is a condition that threatens the limb and needs to be evaluated by a doctor.
- Pus discharge from the pin sites. This is an indication of a serious infection in the bone or surrounding soft tissue. You may need to start antibiotics and explore the source of the pus.
- Worsening pain. This could be the only pointer to deep bone infection. You need to see your doctor for advice on the best way forward.
Complications of pin site infection
- Osteomyelitis;
This refers to an infection in bone. The infection can course from the skin or the surrounding soft tissue to the bone. This is a much harder and more expensive problem to take care of therefore stopping the pin site infection in its tracks is very crucial.
- Pin loosening.
In cases of severe infection, the bacteria can tract down to the pin and eat up part of the bone in contact with the bone which will cause the loosening of the pin. If the bone is loose then this interferes with the stability of the construct that is keeping the bone together so it will delay healing.
In conclusion, proper care for pin sites is quite simple and can even be done in your living room. This can prevent the many complications that may follow their use.
