Infection

Pin Site Infection (PSI) has been described as so common that “it seems reasonable to consider it unavoidable”. Infection can range from local soft tissue infection and cellulitis to osteomyelitis, bacterial endocarditis and septic arthritis, in severe cases this may progress to septicaemia. In many cases minor infection can be remedied with increased pin site care and antibiotic therapy, whereas major infection requires prolonged treatment with systemic antibiotics and often the removal of pins. Recognising infection of the pin site or surrounding tissues is essential to enable effective early management of infection. Classification of PSI varies within the literature, with some studies using clinical judgement of infection and others preferring to use microbiological diagnosis of infection. Many pin site grading tools are complex and time consuming for clinicians to use with varying inter-rater reliability when classifying or grading the extent of erythema, tenderness and swelling of an infected pin site. Clint et al system offers a simplistic approach, which classifies pin sites as ‘Good’, ‘Bad’ or ‘Ugly’, based on factors such as erythema and pain. Similarly, Santy J criteria describes pin sites as ‘calm’, ‘irritated’ or ‘infected’ and takes into account patient and clinician observations.

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Last date updated on September, 2024