Before you leave hospital you will have been taught how to care for your pin sites. Care of the fixator can be daunting, so the aim of this leaflet is also to give you this information in written form.
Pin site care is important because the wires and / or half pins pass through the skin and muscles and into the bone. This increases the risk of an infection on the skin spreading down into the bone.
Pin sites may fall into one of three categories; ‘calm’, ‘irritated’ or ‘infected’. These categories are explained in detail in the following section of this booklet. If the pin sites are ‘calm’ we recommend cleaning the pin sites every 5-7 days. If the pin sites are irritated or infected, you should clean the sites and change the dressings as soon at the dressing becomes saturated. In all 3 cases the pin sites should be dressed after they have been cleaned. Dressings should be removed before showering the limb or attending hydrotherapy or swimming sessions.
You should always check your pin sites for signs of infection when you clean them, or in between if you are concerned that they may be infected.
If your external fixator is being used to correct the position or length of your bone, you will normally start to adjust your fixator 6 - 7 days after your operation. Individual instructions will be given and you will be supported until you feel confident and competent to carry out the adjustments to the frame.
There should be no discharge, swelling, pain or tenderness where the pin or wire enters the skin. It should look like an ear piercing.
Pin sites may become irritated or inflamed, which shows as a redness around the wire or pin. The site may also ooze a clear straw-coloured fluid (exudate). This tends to occur in the first couple of weeks after the operation or when the position of the bone is being adjusted, this happens because the wire is being pulled through the skin.
The skin surrounding wires near to joints such as the knee, ankle, or elbow can also become irritated and ooze after exercise or increased activity. Sometimes adding extra padding to the pin site dressing can help reduce skin movement around the wire. An irritated pin site is not an infected pin site. Dressings may need changing more frequently than normal.
The signs of an infected pin site are:
- Increased pain in the area
- Spreading redness of the skin
- Increased discharge or pus (not always present)
- Increased swelling
- Difficulty weight bearing
- You have a temperature or feel unwell
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