Assessing and managing pin sites in patients with external fixation

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In this article…• Support needs of patients with external fixator devices• Salient points of UK consensus guidance on pin site care• Multifaceted role of nurses in assessing and managing pin sitesAuthor Jennie Walker is divisional lead for research and innovation, surgery division, Nottingham University Hospitals Trust. External fixation is used in orthopaedics to treat complex musculoskeletal conditions. External fixator devices disrupt patients' activities of daily living and often have a negative effect on their psychosocial wellbeing. The devices are held in place by pins and wires, and the sites where these enter the skin are called pin sites. Pin site infection is a common problem and needs to be recognised and treated effectively to avoid serious complications (which include amputation). This article provides an overview of pin site assessment and management, describing the role of nurses in supporting patients, educating them in pin site care, and assessing and treating pin site infection.Citation Walker J (2018) Assessing and managing pin sites in patients with external fixation. Nursing Times [online]; 114: 1, 18-21.Key pointsExternal fixation is used in orthopaedics to manage complex fractures or limb deformityPatients often struggle to cope with external fixator devices and need holistic assessment and supportPin site infection is the most common complication seen with external fixator devicesTo avoid complications, pin site infection must be recognised and treated before it becomes severeUsing a clinical assessment tool improves the reliability of pin site assessment

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