PIN SITE CARE

Leave bandages in place until your first office.

Leave bandages in place until your first office.

Your frame will have ace-bandages wrapped around it when you go home from the hospital. Leave these bandages in place until the nurse removes them at your first office visit which is usually 7-10 days after surgery. You will begin performing your own daily pin care after the first office visit. During the first few weeks after the frame is placed it is normal to have some drainage from the pin sites. You should not get the frame wet while your incisions are healing during the few weeks. Keep the frame covered with a cast cover or trash bags reinforced with tape while you bathe or sponge bathe during this time. Once the wounds are healed and the sutures are removed, showers are permitted. Most patients are allowed to shower with frame exposed after 3 weeks. Consider placing a rubber mat in the shower, a shower chair, a handheld shower hose, or installing handrails in the shower for safety.  

Daily Pin Care

 1.  Gather supplies and wash hands.

 2.  Remove the old dressings and Inspect sites of redness, swelling, drainage, or foul odor.

 3.  (optional) When showering use a liquid antibacterial soap (Dial, Softsoap, etc.) to clean the pin sites and frame. Allow the soap and water to run down the extremity with the frame. Do not scrub too aggressively. Rinse and then dry the frame and nearby skin thoroughly. Dry the fixator with a towel and you can finish the drying process with a hair dryer on cool.

4.   After showering or when not showering, clean the pin sites with cotton swabs or gauze sponges soaked in alcohol mixed with a small amount of hibiclens. Use a new sponge after cleaning 3 pins. If you have an infected pin, use a separate sponge to clean that pin so you don't spread the infection to your other pins. Gently press down on the skin while rolling the gauze away from the pin site. Remove all the dried blood or crust from around the pin.  It may help to use a “dental floss” motion by pulling the gauze back and forth around the pin to clean the area. 

5.    Once the pin sites are clean. Take a new gauze sponge soaked in the alcohol-hibiclens mixture. Wring it out so it's not soaked and wrap the sponge around the pin site to be left in this position until the next cleaning.

 

Pin sites appropriately dressed with sponges.
Pin sites appropriately dressed with sponges.

 Pin care should be performed once each day. It is best to set a routine for yourself and clean your pins at the same time each day. Many patients feel that the best time is after a shower when the pins are already much cleaner. 

MEDICAL SUPPLIES

 It will be necessary to have the proper supplies for cleaning your pins. Talk with your insurance carrier to find out if dressing supplies are covered. You may have to purchase some supplies on your own and multiple medical supply stores in Chattanooga can help you. You will need 4x4 gauze, hibiclens, and alcohol. 

 SYMPTOMS AND TREATMENT OF PIN INFECTION

 Localized infection around a pin is routinely encountered and generally does not lead to any serious complications. If you notice any of these signs or symptoms then begin treating the infected pin as outlined below:

 Signs and Symptoms of infection:

  • Redness around the pin. Small areas of red or purple from scar formation at a pin is normal.  
  • Excessive warmth in the area of the pin.
  • Excessive swelling around the pin.
  • Consistent drainage from the pin.
  • Temperature (orally) greater than 101.4. 

Treatment of pin site infections should begin as soon as you suspect infection:

 1.  Pin care is increased to twice a day. Clean the infected pin site with hydrogen peroxide during these cleanings. Rinse off the excess peroxide with saline as it can irritate the skin.

 2.  Start oral antibiotics. Take the Keflex for at least 5 days. You should keep a prescription filled for this purpose.  If you need refills, call your pharmacy and have them send a request to our office.  

 3.  Keep the pin wrapped with the typical alcohol-hibiclens gauze dressing after you clean it.

 4.  Call the office during business hours to notify our staff at 423-778-5995.

 

The upper pin is infected and oral antibiotics would be appropriate. The middle pin appears to be resolving from a previous infection. The lower pin is an example of a healthy pin site.

The upper pin is infected and oral antibiotics would be appropriate. The middle pin appears to be resolving from a previous infection. The lower pin is an example of a healthy pin site.