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The PINS Trial: a prospective randomized clinical trial comparing a traditional versus an emollient skincare regimen for the care of pin-sites in patients with circular frames.
Ferguson, David; Harwood, Paul; Allgar, Victoria; Roy, Anu; Foster, Patrick; Taylor, Martin; Moulder, Elizabeth; Sharma, Hemant.
Afiliação
  • Ferguson D; Trauma & Orthopaedics, James Cook University Hospital, Middlesbrough, UK.
  • Harwood P; Limb Reconstruction Unit, Leeds General Infirmary, Leeds, UK.
  • Allgar V; Orthopaedics, Hull and East Yorkshire Hospitals NHS Trust, Hull, UK.
  • Roy A; United Lincolnshire Hospitals NHS Trust, Lincoln, UK.
  • Foster P; Limb Reconstruction Unit, Leeds General Infirmary, Leeds, UK.
  • Taylor M; Limb Reconstruction Unit, Leeds General Infirmary, Leeds, UK.
  • Moulder E; Orthopaedics, Hull and East Yorkshire Hospitals NHS Trust, Hull, UK.
  • Sharma H; Orthopaedics, Hull and East Yorkshire Hospitals NHS Trust, Hull, UK.
Bone Joint J ; 103-B(2): 279-285, 2021 Feb.
Article em En | MEDLINE | ID: mdl-33517738
ABSTRACT

AIMS:

Pin-site infection remains a significant problem for patients treated by external fixation. A randomized trial was undertaken to compare the weekly use of alcoholic chlorhexidine (CHX) for pin-site care with an emollient skin preparation in patients with a tibial fracture treated with a circular frame.

METHODS:

Patients were randomized to use either 0.5% CHX or Dermol (DML) 500 emollient pin-site care. A skin biopsy was taken from the tibia during surgery to measure the dermal and epidermal thickness and capillary, macrophage, and T-cell counts per high-powered field. The pH and hydration of the skin were measured preoperatively, at follow-up, and if pin-site infection occurred. Pin-site infection was defined using a validated clinical system.

RESULTS:

Out of 116 patients who were enrolled in the study, 23 patients (40%) in the CHX group and 26 (44%) in the DML group had at least one bad or ugly pin-site infection. This difference was not statistically significant (p = 0.71). There was no significant relationship between pH or hydration of the skin and pin-site infection. The epidermal thickness was found to be significantly greater in patients who had a pin-site infection compared with those who did not (p = 0.01). Skin irritation requiring a change of treatment occurred in four patients (7%) using CHX, and none using DML.

CONCLUSION:

We found no significant difference in the incidence of pin-site infection between the CHX and DML treatment groups. Dermol appeared to offer a small but significant advantage in terms of tolerability. We did not find a significant association between patient or treatment related factors and pin-site infection. It is therefore difficult to make specific recommendations based upon these results. The use of either cleaning agent appears to be appropriate. Cite this article Bone Joint J 2021;103-B(2)279-285.
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Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Cuidados Pós-Operatórios / Fraturas da Tíbia / Pinos Ortopédicos / Fixadores Externos / Infecções Relacionadas à Prótese / Emolientes / Fixação de Fratura Tipo de estudo: Clinical_trials / Guideline / Incidence_studies / Observational_studies / Prognostic_studies / Risk_factors_studies Limite: Adolescent / Adult / Aged / Aged80 / Female / Humans / Male / Middle aged Idioma: En Revista: Bone Joint J Ano de publicação: 2021 Tipo de documento: Article

Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Cuidados Pós-Operatórios / Fraturas da Tíbia / Pinos Ortopédicos / Fixadores Externos / Infecções Relacionadas à Prótese / Emolientes / Fixação de Fratura Tipo de estudo: Clinical_trials / Guideline / Incidence_studies / Observational_studies / Prognostic_studies / Risk_factors_studies Limite: Adolescent / Adult / Aged / Aged80 / Female / Humans / Male / Middle aged Idioma: En Revista: Bone Joint J Ano de publicação: 2021 Tipo de documento: Article