Prevalence of Pin Tract Infection: The Role of Combined Silver Sulphadiazine and Chlorhexidine Dressing

Abstract

Infection at the pin tract is a common complication of external fixation. This study was done to compare the rate of pin site infection following combined 1 % silver sulphadiazine and 5 % chlorhexidine dressing with 5%chlorhexidine dressing alone. This was a prospective controlled study which compared the results of pin site dressing using a combination of chlorhexidine and silver sulphadiazine cream(Study group)with dressing using chlorhexidine alone. Eligible patients had external fixation in the treatment of open fractures or orthopaedic conditions. Pintract infectionwas deemed to be present if erythema, cellulitis or purulent discharge occurred around a pin site. We did not distinguish between deep and superficial infection. The study group had one hundred and seventy pin sites while the control group had one hundred and sixty-four pin sites. Thirty-eight patients, in whom thirty-seven uniplanar external fixators and one Ilizarov ring fixator were used, made up both groups. Three patients (7.9%) had pin tract infection in the study group while nine patients (23.7%) had pin tract infection in the control group. Therewas a significantly lower prevalence of pin-tract infection amongst patientswhose external fixation pins were dressed with 1 % silver sulphadiazine and 5 % chlorhexidine than in those dressed with chlorhexidine alone (P=0.03). Therefore, we advocate the use of a combination of silver sulphadiazine and chlorhexidine for pin site dressing.

Keywords: External fixation, Prevalence, Pin-tract Infection,Dressings.