Title: To find out the effectiveness of normal saline versus povidone iodine on Pin Site Infection among patients with external skeletal fixators admitted in a tertiary care hospital, Thiruvananthapuram

Authors: Joby Krishna, Dr Balagopalan K, Dr Sabarisree M

 DOI: https://dx.doi.org/10.18535/jmscr/v8i5.80

Abstract

 

Need and Significance of the Study

To date, a standard for pin site care that has been proven to be effective in preventing infection has yet to be identified. There is very little evidence to say that which pin site care regimen is best to reduce the infection rates. So an attempt is made to see that which existing practices are better for prophylaxis of pin site infection cases. Preventing infection of skeletal pin sites of patients with skeletal traction pins or external fixator pins is a nursing priority. Being nursing personnel, it is a need to find out the most effective protocol to reduce the number of pin site infection cases. This motivated me to do study on this topic. 

This study is undertaken to high-lighten the effective protocol in preventing of pin site infection. The  study  will be  useful  for the  nurses  to  enlighten  their  knowledge  regarding  pin site   care  and  observation .By  that  it  helps  prevention  of pin site  infection  among  patients  who are  in external skeletal fixators. If the pin care has been properly done, the skin will rapidly heal around the pins and the discharge stops. It is therefore important to identify pin site infection earlier. Special care of the fixator and pin tracts are necessary to prevent infection and unsuccessful healing of the fracture. If the pin care has been properly done, the skin will rapidly heal around the pins and the discharge stops. It is therefore important to identify pin site infection earlier.

Statement of the Problem

A study to assess the effectiveness of pin site care with normal saline versus povidone iodine on Pin Site Infection among patients with external skeletal fixators  admitted in a tertiary care hospital ,Thiruvananthapuram.

Objective of the Study

To find out the effectiveness of normal saline versus povidone iodine on Pin Site Infection among patients with external skeletal fixators admitted in a tertiary care hospital, Thiruvananthapuram.

References

  1. P R Asalatha and Deepa ,Text book of Anatomy and Physiology ,Jaypee brothers medical publoshers,page no;112-116.
  2. P. Cherepanov, Mechanics of brittle fracture; International Journal of Fracture 12, Nauka Publishers, Moscow 785–787 (1976) .
  3. https://www.who.int/news-room/fact-sheets/detail/road-traffic-injuries
  4. Traffic accidents, NCRB 2016 Report, Chapter 1A: Traffic Accidents, Government of India.
  5. Gururaj (2008), Road traffic deaths, injuries and disabilities in India: Current scenario, The National Medical Journal of India, volume 21, no 1, page 116
  6. Goel, Rahul (2018). "Modelling of road traffic fatalities in India". Accident Analysis & Prevention. Elsevier BV. 112: 105–115.
  7. Road traffic deaths and proportion of road users by country/area, who (2015 report)
  8. WHO, ed. (2015). Global Status Report on Road Safety 2015 (PDF) (official report). Geneva: World Health Organisation (WHO). pp. vii, 1–14, 75ff (countries), 264–271 (table A2), 316–332 (table A10). ISBN 978-92-4-156506-6. Retrieved 27 January 2016.
  9. Anil Radhakrishnan, When roads wreak devastation, The Hindu, Thiruvananthapuram, march 10, 2019.
  10. Ren-Hao Pan, Nien-Tzu Chang, Dachen Chu, Kuo-Fang Hsu, Yuan-Nian Hsu, Jin-Chyr Hsu, Lin-Yu Tseng and Nan-Ping Yang , Epidemiology of Orthopedic Fractures and Other Injuries among Inpatients Admitted due to Traffic Accidents: A 10-Year Nationwide Survey in Taiwan,  The Scientific World Journal ,Volume 2014 |Article ID 637872.
  11. Schlich (2002) Surgery, Science and Industry. A Revolution in Fracture Care, 1950s1990s (Houndsmills, Basingstoke: Palgrave)
  12. Seligson D, Mauffrey C, Roberts S C, External fixation in traumatology, 3rdedition,springer publishers,pp;378-379.
  13. Renegar WR, Leeds EB, Olds RB. The use of the Kirschner-Ehmer splint in clinical orthopedics. Part 1: Long bone and mandibular fractures. Comp Contin Educ Pract Vet. 1982;4:381–392.
  14. Anderson MA, Aaron DN, Palmer RH. Improving pin selection and insertion technique for external skeletal fixation. Comp Contin Educ Pract Vet. 1997;19:485–494.
  15. Prevalence of pin-site infection: the comparison between silver sulfadiazine and dry dressing among open tibial fracture patients.
  16. Suresh K. Sharma, JogindraVati, lndarjit Walia, Ramesh Sen; Prevalence of pin site infection am0ng patients with external skeletal fixation, Nursing and Midwifery Research Journal, Vol-1, No. 2, April 2005 ,page no 124-130.
  17. Ferreira, Pin tract sepsis Incidence, Medical Perspectives. International Journal of Orthopaedic. 2006 Mar 2; 29(4):33-38
  18. Egol KA, Paksima N, Puopolo S, Klugman J, Hiebert R, Koval KJ. Treatment of external fixation pins about the wrist: a prospective, randomized trial. J Bone Joint Surg Am. 2006; 88 (2):349–354.
  19. Henry C. Pin Sites: do we need to clean them? Practical Nursing. 1996; 7(4):12–17.
  20. Patterson MM. Multi-center pin care study, Orthopaedic Nurses. 2005;24(5): 349–360.
  21. Camathias C, Arandomised, prospective, blinded controlled study on routine pin tract care in external fixation in Switzerland, Sao Paolo Medical Journal 2005;123(2):58–61.
  22. Aa Burns and Grove’s The Practice of Nursing Research, 8th Edition - 9780323377584 [Internet]. [cited 2019 May 31]. Available from: https://evolve.elsevier.com/ cs/product/9780323377584?role=student
  23. Nursing Research and Statistics - 2nd Edition [Internet]. [cited 2019 May 31]. Available from: https://www.elsevier.com/books/nursing-research-and-statistics/ suresh/978-81312-3308-5
  24. Nursing Research and Statistics - 2nd Edition [Internet]. [cited 2019 May 31]. Available from: https://www.elsevier.com/books/nursing-research-and-statistics/ suresh/978-81312-3308-5
  25. Polit DF, Hungler BP. Nursing Research: Principles and Methods, 6th edition. 6th Philadelphia: Lippincott Williams & Wilkins; 1999. 150 p.
  26. O M Babalola, Oni Nasiru Salawu, B A Ahmed ,G H Ibraheem ,A Olawepo, S B Agaja, Epidemiliogy of traumatic fractures in a tertiary heaith center in Nigeria, Journel of Orthopaedics, Traumatology and Rehabilitation ,2018,volume ;10,page no; 87-89.
  27. Edward Kironde, Patrick Sekimpi, Issac Kajja ,Paul Mubiri, Prevalence and patterns of traumatic bone loss following open long bone fractures at Mulago hospital,Ota International 2[1],e015,2019.
  28. Deba Prasad Dhibar, Yashpal Gogate, Sameer Aggarwal, Sudhir Garg, Anil Bhansali, Sanjay Kumar Bhadada, Predictors and outcome of fragility  hip fracture ;a prospective study from North India, Indian Journal of Endocrinology and Metabolism,2019,volume;23,page no;282-288
  29. Babalola O M, Salawu ON, Ahmed B A, Ibraheem G H, Olawepo A, Agaja S B. Epidemiology of traumatic fractures in a tertiary health center in Nigeria. Journal of Orthopaedic Traumatoly and Rehabilitation  2018;10:87-9
  30. Kironde, Edward MBChB, MMED, (MUK)a, Sekimpi, Patrick MBChB, MMED, (MUK), FCS, (ECSA)a,b; Kajja, Isaac MBChB, MMED, (MUK), PhD, FCS, (ECSA)a,b; Mubiri, Paul B.Stat, M.Statc Prevalence and patterns of traumatic bone loss following open long bone fractures at Mulago Hospital, OTA International: March 2019 - Volume 2 - Issue 1.
  31. Dhibar DP, Gogate Y, Aggarwal S, Garg S, Bhansali A, Bhadada SK. Predictors and outcome of fragility hip fracture: A prospective study from North India. Indian Journal of Endocrinology and Metabolism 2019;23:282-8.
  32. Aishwarya T V, Aleena Sunny, Priya Biji, Britto Duraisingh L, Mohanraj KP, Sivakumar T A Case Control Study on the Incidence and Prevalence of Hip Fracture in Association with Hypoglycemic Drugs Among Type II Diabetic Patients in a Major Trauma Care Center Indian Journal of Pharmacy Practice, 2019; 12(1):30-33
  33. Khadilkar, A.V., Ekbote, V.H., Chiplonkar, S.A. et al. Fractures in School Going Children. Indian Journal of Paediatrics 82, 871 (2015). 
  34. Awasthi B, Raina SK, Kumar N, Sharma V, Kalia S, Thakur L. Pattern of extremity fractures among patients with musculoskeletal injuries: A hospital based study from North India. Journal of Medical  Society  2016;30:35-7
  35. Sabarisree M, Jyothiprasanth M, Babu S, et al. A Study on Functional Outcome of Comminuted Supracondylar Fracture Femur Treated by Plating with Fibular Bone Grafting. Journal of Bone Research Reports ,2017, 3:1. doi: 10.4172/2469-6684.100038
  36. Ravikumar Rajappan, Dr. Ravikumar V and Dr. Suhail AP Functional outcome of tibial plateau fractures, Schatzker type V and VI treated surgically with plate osteosynthesis National Journal of Clinical Orthopaedics 2018; 2(2): 35-46.
  37. Huda A Princy Prasad M.R., Chandrakumar G, C.S. Sivakumar, a comparative study to evaluate the efficacy with murivenna and plaster of paris in the management of colles fracture International Ayurvedic Medical Journal (ISSN: 2320 5091)   volume 2, issue 3, February-march, 2018 Impact Factor: 4.018  ,991-997.
  38. Yong Yang ,Arandomised controlled trial  on the application of external fixator and limited  internal fixation in combined treatment of  limb fractures in China, Journal of Orthopaedic nursing. 1991;14:(3)305-8.
  39. Yau Zakari  Lawal, observational study  on  mono-lateral  frame  external  fixators  in the  definitive  management  of open  limb  fractures   in North –western Nigeria, Orthopaedic Reviews (Pavia) 2009 Oct;1(2) : 18.

Corresponding Author

Dr Balagopalan K

Additional Professor in Orthopaedics, Govt Medical College, Thiruvananthapuram