Pin Care

Some types of braces, skeletal traction, and external fixators use pins. These devices also may have rods and clamps that help hold broken bones in place while they heal. With these devices, a pin makes a direct pathway to the bone. This pathway to the bone increases the risk of infection. If you have one of these devices, it is extremely important to keep the pin and the skin around it as clean as possible to help prevent infection.

Pin care is the process of cleaning a pin and the skin around where the pin enters the body. Good care of the pin and the pin site is very important to prevent infection.

Preparation

Do pin care 1 to 3 times a day, as directed by your doctor. Place the following items close at hand before you begin:

• A clean, 4- to 8-ounce container with lid
• Normal saline (you can buy this at most drug stores)hydrogen peroxide (you can buy this at most drug stores)
• A pen or marker
• Blue pads or a clean towel
• Clean cotton swabs (like Q-tips). You will need a lot of these.
• Betadine or antibiotic ointment, if ordered by your doctor

In the container, mix equal amounts of hydrogen peroxide and normal saline. For instance, mix 1/4 cup of hydrogen peroxide with 1/4 cup of normal saline. Mark the container with the name of the solution and the date it was mixed. You may save and use the same solution for up to 24 hours.

Cleaning the area

1. Wash your hands thoroughly.
2. Place a blue pad or a clean towel under the area to be cleaned.
3. Clean the skin around each pin this way: Wet a cotton swab with the solution you mixed. Place the swab where the pin enters the skin. Then make one stroke outward on your skin with the swab, moving away from the pin. Throw the swab away. Take another swab, dip it in the solution and make another stroke outward from the pin. Throw the swab away. Using a new
   cotton swab for each stroke, clean until you have made a complete circle around the pin. If the cotton swab has cotton at both ends, you may use the other end of the swab before throwing it out. Use each cotton tip only once.
4. As you are cleaning the skin around the pin, pull the skin away from the pin with the cotton swab. Use the swab to remove any crust at the pin site. Remove the crust by making an outward stroke from the pin site. If you need to make several strokes to remove crust, use a clean swab for each stroke.
5. Look for signs of infection at the pin site. Signs of infection include redness, increased pain, swelling, pus-like drainage, or black tissue around the pin site. If you notice any of these signs, call your doctor or nurse immediately.
6. The next step is to clean the pin itself with a cotton swab and the solution. Wet the swab with the solution. Place the swab where the pin enters the skin and make a stroke along the pin, moving away from your skin. Throw the swab away. Using a new cotton swab for each stroke, clean the entire pin.
7. In some cases, your doctor may order an ointment to be applied around the pin site. Your doctor will tell you what ointment to use if needed. Put a small amount of the ointment on a cotton swab. Place the swab where the pin enters the skin. Then make a stroke along the pin, moving away from your skin. Discard the swab. Use a new swab for each pin.
8. Put used cotton swabs and any used blue pads in the trash.
9. Wash your hands thoroughly.
10. The solution may be saved and used again for up to 24 hours. Be sure to seal the container. Keep the container of solution out of the reach of children.

When to call the doctor

If you notice any of the following signs of infection, call your doctor or nurse immediately:

• Redness at the pin site
• Increased pain at the pin site
• Swelling at the pin site
• Pus-like drainage from the pin site
• Black tissue around the pin site
• Fever of 101 F (38.3 C) or above
• Chills

Call your doctor or nurse with any questions or concerns you may have about pin care.

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