Prevention of pin-site infection : a comparison between antimicrobial dressings and passive dressings

Abstract

Background: External fixator pin-sites are prone to infections, hence certain precautions are taken to reduce this risk. One precaution is the use of dressings to cover the pin-site from the external environment. However, literature has not narrowed down which type of dressing is most effective in preventing infection. This systematic review was carried out to identify which type of dressing is most effective between antimicrobial dressing and passive dressings. PICO question: ‘In patients with an external fixator device, do antimicrobial dressings compared with passive dressings reduce pin site infection?’ PICO Elements: Population (P)- external fixator pin-sites, Intervention (I) -Antimicrobial dressing, Comparison (C)-Passive dressing, Outcomes (O) - Prevention of infection Method: The PICO question was followed by a thorough literature search using three trustworthy databases. The research question's most relevant papers were those that met the inclusion and exclusion criteria. Peer-reviewed publications, the English language, papers released after 2010, meta-analyses, systematic reviews (SR), randomized controlled trials (RCT), cohort studies, experimental studies and cross-sectional studies, were among the inclusion criteria. Whilst the exclusion criteria characteristics were: Internal fixator/ no pin-sites, antimicrobial solutions/ cleansing, any studies that focused on other outcomes, literature reviews, online informal articles, opinion articles, non- English language studies, species other than human. Four randomised controlled studies were found after a thorough search. The appropriate Critical Appraisal Skills Programme (CASP) technique was utilised to critically evaluate the studies selected. Results and conclusion: According to the studies found, antimicrobial dressings significantly reduced the number of pin-site infections in two out of the four studies. However, given the limitations of these studies, careful interpretation of the findings was essential, and additional study is advised. Implications and recommendations: For reliable proof of the efficacy of this strategy, more research on antimicrobial pin-site dressings is required. Additionally, it is crucial to educate students and healthcare professionals about the evaluation of pin sites and the necessary dressings. It was also advised that local clinical guidelines be implemented after considering the available evidence.