Abstract
Superficial infection at wire and pin insertions in the skin is a frequent disorder among patients utilizing the Ilizarov method. The objective of this study was to evaluate the effectiveness of daily topical application of 10% polyvinylpyrrolidone-iodine solution against infections of the holes for Kirschner wires and Schanz pins among patients using Ilizarov external fixators, in comparison with cleaning these holes only with 0.9% sterile physiological saline solution. Controlled randomized clinical trial, in the Orthopedics and Traumatology Outpatient Clinic, Hospital São Paulo, and Orthopedics and Traumatology Center of Jundiaí. 30 patients were treated using the Ilizarov technique: 15 were instructed to apply 0.9% physiological saline dressing on the wire and pin insertions and 15 to apply 0.9% physiological saline plus 10% polyvinylpyrrolidone-iodine. Patients were evaluated at outpatient return visits for identification of signs and symptoms of superficial infection at wire and pin insertion sites. Samples were collected from cases of purulent exudate secretion, for culturing and clinical tests. The chi-squared and Fischer exact tests were applied, but no statistically significant association between the intervention of topical polyvinylpyrrolidone-iodine solution and the prevention of infections at wire and pin insertions could be found. Topical 10% polyvinylpyrrolidone-iodine solution applied daily to Kirschner wire and Schanz pin insertions did not reduce the incidence of superficial infection at these holes, in comparison with mechanical removal of dirt using 0.9% physiological saline solution.
Highlights
Topical 10% polyvinylpyrrolidone-iodine solution applied daily to Kirschner wire and Schanz pin insertions did not reduce the incidence of superficial infection at these holes, in comparison with mechanical removal of dirt using 0.9% physiological saline solution
Several studies have shown that skin infections adjacent to wire and pin insertions are frequent complications of the Ilizarov method
The purpose of the present study was to evaluate the effectiveness of topical polyvinylpyrrolidone-iodine solution in comparison with the use of only 0.9% saline, with regard to mechanical and healing cleaning of the skin adjacent to the insertions of Kirschner wires and Schanz pins in the prophylaxis of superficial infection at wire and pin insertions
Summary
Several studies have shown that skin infections adjacent to wire and pin insertions are frequent complications of the Ilizarov method. Such infections have been associated with loss of wire tension, abscess formation around the wire or pin, presence of necrotic tissue all along the wire or pin and bad cleaning of the pins and wires when applying dressings.[1,2,3] The presence of foreign bodies in the organism irritates tissues and favors infection. The antimicrobial drugs of choice must be wide-spectrum, hypoallergenic and present reduced side effects.[5] Today, a topical antiseptic solution of 10% polyvinylpyrrolidone-iodine is, according to the Brazilian Ministry of Health,[6] the only acceptable formulation for use in dressings. The purpose of the present study was to evaluate the effectiveness of topical polyvinylpyrrolidone-iodine solution in comparison with the use of only 0.9% saline, with regard to mechanical and healing cleaning of the skin adjacent to the insertions of Kirschner wires and Schanz pins in the prophylaxis of superficial infection at wire and pin insertions
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