Pin site infection: A systematic review on how surgical techniques applying wires and half-pins affects pin site infection

Abstract

Introduction: Pin site infection continues to be a very common problem when treating patients with external fixators. Wire and half-pin insertion technique may influence the risk of developing a pin site infection and the aim of this study is to investigate existing literature in relation to this. Methods: A systematic review of the literature reporting on surgical techniques in relation to pin site infection was conducted. Studies evaluating the effect of a surgical technique with proposed preventive measures to minimize pin site infection in adults and children undergoing an external fixation for trauma or reconstruction were eligible for inclusion. The primary outcome was pin site infection rate. MEDLINE, EMBASE, CINAHL, Google Scholar, and the Cochrane Central Register of Controlled Trials were searched for the period 1970 to August 2021. Study quality was assessed using the modified Downs and Black checklist. A narrative synthesis was undertaken. Results: Two studies describing two different surgical methods were found eligible for inclusion (one cross-sectional study and one prospective cohort). Neither of the two surgical techniques seemed to affect the pin site infection rate. Conclusion: Literature on this topic is sparse, and at present, there is no convincing evidence to support that one surgical technique applying wires and pins is preventive in relation to pin site infection.