A fresh consensus for pin site care in the UK

SummaryThis consensus project was conceived in the absence of strong evidence for the effective care of pin sites and prevention of infection. The consensus involved a one-day meeting which was used to develop a series of consensus statements. These statements were then used to develop an online questionnaire which enabled participants to express their level of agreement with each statement.The following are a summary of the results of the meeting and subsequent survey:
• It was agreed that, in the absence of skin sensitivity, pin sites should be cleaned weekly using alcoholic chlorhexidine solution (solution strength is not specified) and non-shedding gauze.
• They should then be covered with a wound dressing that keeps excess moisture and exudate away from the wound.
• The dressings should be held in situ with a clip or ‘bung’ in order to apply light compression.
• The frequency of dressing changes should be increased in the presence of an infection or the dressing becoming saturated.
• On the day of dressing change the patient may swim, attend hydrotherapy and shower (not bath) the limb. The surrounding skin should be moisturised with an emollient as necessary.
• Patient reported symptoms and perceptions of the presence of infection should be taken seriously. Increasing pain at the pin/wire site and decreased movement, mobility or weight bearing along with spreading redness and increased swelling and discharge are indicators of the presence of infection. Frank drainage of pus is conclusive of the presence of infection, but is not present in all cases of infection.There is a need for multi-centre prospective randomised controlled trials using a standardised validated pin site assessment tool and regular review of these recommendations along with new developments in wound care.