Department of Orthopaedic Surgery, University Malaya Medical Centre, 50603 Kuala Lumpur, Malaysia.
Clin Orthop Relat Res. 2012 Feb;470(2):610-5. doi: 10.1007/s11999-011-1990-z. Epub 2011 Aug 13.
Pin site infection is a common problem in external fixation. Plain gauze wetted with normal saline is commonly used for a pin site dressing owing to the simplicity and low cost. Evidence to support adding an antimicrobial agent in the dressing material is lacking.
QUESTIONS/PURPOSES: We compared the rate of pin tract infection using plain gauze and gauze impregnated with polyhexamethylene biguanide in patients undergoing limb lengthening procedures.
We included 38 patients (40 limbs) undergoing limb lengthening or deformity correction using an external fixator between July 2009 and June 2010. There were 23 male patients and 15 female patients, with a mean age of 26.3 years (range, 5-68 years). The patients were randomized into two groups: a polyhexamethylene biguanide group (22 limbs) and a control group (18 limbs). The metal-skin interfaces were assessed by a researcher blinded to the type of gauze at 2, 4, 8, and 12 weeks after surgery for the pin site infection based on a predetermined grading system. There were a total of 483 metal-skin interfaces, with 1932 total observations. Infection rates were compared using the chi square test and relative risk with 95% confidence interval.
The infection rate was lower (χ(2) [1, n = 1932] = 23.00) and the risk for infection was lower (relative risk, 0.228; 95% confidence interval, 0.118, 0.443) for the polyhexamethylene biguanide group (n = 1068; 1.0%) than for the control group (n = 864; 4.5%).
Use of polyhexamethylene biguanide-impregnated gauze can reduce the risk of pin tract infection in external fixation.
Level I, therapeutic study. See Guidelines for Authors for a complete description of levels of evidence.
皮钉感染是外固定器常见的问题。由于简单且成本低，临床上常使用生理盐水浸湿的普通纱布来包扎皮钉。但目前缺乏关于在敷料中添加抗菌剂的证据。
问题/目的：我们比较了在接受肢体延长手术的患者中，使用普通纱布和聚六亚甲基双胍浸渍纱布包扎皮钉时的皮钉部位感染率。
我们纳入了 2009 年 7 月至 2010 年 6 月期间使用外固定器进行肢体延长或畸形矫正的 38 例患者（40 个肢体）。其中男 23 例，女 15 例，平均年龄 26.3 岁（5-68 岁）。患者随机分为两组：聚六亚甲基双胍组（22 个肢体）和对照组（18 个肢体）。在术后 2、4、8 和 12 周，由一名对纱布类型不知情的研究人员根据预定的分级系统评估金属-皮肤界面的皮钉部位感染情况。共有 483 个金属-皮肤界面，总计 1932 个观察点。使用卡方检验和 95%置信区间的相对风险比较感染率。
聚六亚甲基双胍组（n = 1068；1.0%）的感染率较低（χ(2) [1，n = 1932] = 23.00），感染风险也较低（相对风险，0.228；95%置信区间，0.118，0.443），而对照组（n = 864；4.5%）的感染率较高。
使用聚六亚甲基双胍浸渍纱布可以降低外固定器皮钉部位感染的风险。
I 级，治疗性研究。欲了解完整的证据等级描述，请参见《作者指南》。
