Abstract | BACKGROUND: Pin site infection is a common problem in external fixation. Plain gauze wetted with normal saline is commonly used for a pin site dressing owing to the simplicity and low cost. Evidence to support adding an antimicrobial agent in the dressing material is lacking. QUESTIONS/PURPOSES: PATIENTS AND METHODS: We included 38 patients (40 limbs) undergoing limb lengthening or deformity correction using an external fixator between July 2009 and June 2010. There were 23 male patients and 15 female patients, with a mean age of 26.3 years (range, 5-68 years). The patients were randomized into two groups: a polyhexamethylene biguanide group (22 limbs) and a control group (18 limbs). The metal-skin interfaces were assessed by a researcher blinded to the type of gauze at 2, 4, 8, and 12 weeks after surgery for the pin site infection based on a predetermined grading system. There were a total of 483 metal-skin interfaces, with 1932 total observations. Infection rates were compared using the chi square test and relative risk with 95% confidence interval. RESULTS: The infection rate was lower (χ(2) [1, n = 1932] = 23.00) and the risk for infection was lower (relative risk, 0.228; 95% confidence interval, 0.118, 0.443) for the polyhexamethylene biguanide group (n = 1068; 1.0%) than for the control group (n = 864; 4.5%). CONCLUSIONS: LEVEL OF EVIDENCE: Level I, therapeutic study. See Guidelines for Authors for a complete description of levels of evidence.
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Authors | C K Lee, Y P Chua, A Saw |
Journal | Clinical orthopaedics and related research
(Clin Orthop Relat Res)
Vol. 470
Issue 2
Pg. 610-5
(Feb 2012)
ISSN: 1528-1132 [Electronic] United States |
PMID | 21842299
(Publication Type: Journal Article, Randomized Controlled Trial)
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Chemical References |
- Biguanides
- Disinfectants
- Metals
- polihexanide
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Topics |
- Adolescent
- Adult
- Aged
- Bandages
- Biguanides
(administration & dosage)
- Bone Nails
(adverse effects)
- Chi-Square Distribution
- Child
- Child, Preschool
- Disinfectants
(administration & dosage)
- Double-Blind Method
- Female
- Fracture Fixation
(adverse effects, instrumentation)
- Humans
- Malaysia
- Male
- Metals
- Middle Aged
- Prosthesis Design
- Prosthesis-Related Infections
(microbiology, prevention & control)
- Risk Assessment
- Risk Factors
- Time Factors
- Treatment Outcome
- Young Adult
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