W-Dahl Annette, Toksvig-Larsen Sören, Lindstrand Anders
Department of Orthopedics, University Hospital, SE-221 85 Lund, Sweden.
Acta Orthop Scand. 2003 Dec;74(6):704-8. doi: 10.1080/00016470310018234.
We investigated whether there were any differences in the frequency and severity of pin site infections by performing pin site care daily or once a week. We studied patients operated on for gonarthrosis by the hemicallotasis technique, using hydroxyapatite-coated pins in the metaphyseal bone and standard pins in the diaphyseal bone.
50 patients were prospectively randomized to daily (n = 27) or weekly (n = 23) pin site care. We evaluated pin sites, the occurrence of pain (VAS), the use of antibiotics and analgesics and complications every week. Bacterial cultures were taken from each pin site at 1, 6 and 10 weeks and from the pins on removal.
We found no differences between daily or weekly pin site care as regards the frequency and severity of pin site infections, pain, or the use of antibiotics and analgesics. Grade I infections (Checketts-Otterburns classification) occurred around 11% of the pins and grade II infections around 4%. 70% of the bacterial cultures were negative. The most frequent bacteria were coagulase negative staphylococcus and corynebacterium. Antibiotics were given an average of 47 days. More problems occurred around the proximal pins. 5/200 (all proximal) pins were clinically loose on removal.
Pin site care once a week seems appropriate.
我们通过每日或每周进行一次针道护理，研究针道感染的频率和严重程度是否存在差异。我们研究了采用半骨骺牵伸技术治疗膝关节病的患者，在干骺端骨使用羟基磷灰石涂层针，在骨干骨使用标准针。
50例患者前瞻性随机分为每日（n = 27）或每周（n = 23）针道护理组。我们每周评估针道、疼痛发生情况（视觉模拟评分法）、抗生素和镇痛药的使用情况以及并发症。在第1、6和10周从每个针道以及取出的针上采集细菌培养样本。
我们发现，在针道感染的频率和严重程度、疼痛或抗生素和镇痛药的使用方面，每日或每周针道护理之间没有差异。I级感染（Checketts - Otterburns分类）发生在约11%的针周围，II级感染约为4%。70%的细菌培养结果为阴性。最常见的细菌是凝固酶阴性葡萄球菌和棒状杆菌。抗生素平均使用47天。近端针周围出现的问题更多。5/200（均为近端）根针在取出时临床上松动。
每周进行一次针道护理似乎是合适的。
