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Antimicrobial Gauze as a Dressing Reduces Pin Site Infection: A Randomized Controlled Trial
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Antimicrobial Gauze as a Dressing Reduces Pin Site Infection: A Randomized Controlled Trial
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Journal Article
Antimicrobial Gauze as a Dressing Reduces Pin Site Infection: A Randomized Controlled Trial
2012
Overview
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
We compared the rate of pin tract infection using plain gauze and gauze impregnated with polyhexamethylene biguanide in patients undergoing limb lengthening procedures.
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
Use of polyhexamethylene biguanide-impregnated gauze can reduce the risk of pin tract infection in external fixation.
Level of Evidence
Level I, therapeutic study. See Guidelines for Authors for a complete description of levels of evidence.
Publisher
Springer-Verlag,Springer,Lippincott Williams & Wilkins Ovid Technologies
Subject
/ Adult
/ Aged
/ Bandages
/ Biguanides - administration & dosage
/ Biological and medical sciences
/ Bone Nails - adverse effects
/ Child
/ Diseases of the osteoarticular system
/ Disinfectants - administration & dosage
/ Female
/ Fracture Fixation - adverse effects
/ Fracture Fixation - instrumentation
/ Humans
/ Malaysia
/ Male
/ Medicine
/ Metals
/ Prosthesis-Related Infections - microbiology
/ Prosthesis-Related Infections - prevention & control
/ Surgery
