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Info/Ed Report
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External fixation pin care protocol utilizing ionic silver site dressings* Cameron Field, DPM, Kenneth Morgan, DPM, HealthOne Alliance Presbyterian/St. Luke's, Denver, CO PROBLEM: The use of external fixation has greatly increased over the past decade. The main disadvantages of external fixation are the high likelihood of pin tract infections and the time constraints related to regular dressing changes. The advantages of external fixation include decreased operating room time, the ability to use with comminuted bone, in the presence of infection, to weight bear post-operatively, and the ability to remodel a dislocated extremity and bring it back into anatomical alignment with computer guided manipulation. DISCUSSION: Silver has been shown to be an effective antimicrobial agent. Studies have shown that silver can inhibit bacterial growth by 99.99%. Other studies have shown that a sustained release of ionic silver can inhibit bacterial growth for up to seven days. Ionic Silver Site Dressing has been shown to be effective at absorbing exudate. RESULTS AND CONCLUSION: We present an external fixation pin care protocol that has decreased the number of pin tract infections as well as decreased the dressing change time and interval. Ionic silver site dressings* are circular pads that allow for easy placement over an external fixation wire. The radial slit with a center notch allows it to easily slide through a wire so that there are no gaps present around the pin site. Once the highly absorbent dressing is in place, a transparent film is placed over the dressing to allow for a controlled environment. The frequency of dressing changes will depend on the amount of exudate. The dressing can remain in place for up to 7 days with effective antimicrobial coverage without macerating the skin .*SilvaSorb Site Dressing from Medline Industries, Inc, Mundelein, IL. |
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