Physician's Resources: Pin Site Care for External Fixation

Skin infection is a realistic concern. For this reason, appropriate pin care and wire cleaning are necessary after the application of an external fixation device

  • No showering for approximately 5-7 days after external fixator application.
  • If you have open wounds, you cannot get the external fixator wet.
  • If stitches or staples are in place, you may not get tem wet until they're removed.
  • The best method for keeping the fixator dry, is to place a small plastic bag over the involved portion of the extremity. Fold a washcloth in half so that half is inside the bag and the other half is on the outside of the top of the bag. Cover the entire circumference of the extremity with the washcloth. Place a rubber-band over the top of the bag, over the washcloth. Your recovery nurse can also provide a 'shower bag'.
  • It is normal to expect clear yellow or bloody drainage from the pin sites within a few days after the procedure.
  • Clean the pin sites with normal saline to remove the drainage. Start at the pin site and move in circular motion outward. Cotton swabs may be used to clean the area. Do not be overly aggressive with cleaning, as this will irritate the skin and increase redness, tenderness, and/or infection.
  • Remove dried blood and scabs from skin around pins with the same method.
  • Clean the wires with the same technique.
  • When showering, clean the pin sites and wires with water and an antibacterial liquid soap. Allow the soap and water to run down the extremity, no scrubbing. Rinse and dry. May dry on a cool setting of a hair dryer. No bathing, soaking in contaminated water increases infection risks.

Pin-Tract Infections

  • Redness, warmth, swelling at pin sites
  • Increased tenderness
  • Fever over 100.5º F
  • White, green, or yellow thick, cloudy drainage
  • Distinct color or odor
  • Oral antibiotics may be used if warranted by doctor -First-Line Antibiotic Care: 1st generation Cephalosporins -Second-Line Antibiotic Care: Cipro