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Evidence-Based Practice Nursing

External fixation of limbs is a common feature of orthopedic care globally. It is used in acute care and also in planned, late correction of deformity or in the management of infection. The field of external fixation is impacted by multiple variables including the surgical technique and mechanics of the frame applied, the underlying injury or disease, and the individual to which the frame is applied.

Pin site complications threaten the ability of the frame to provide the biomechanical conditions required for its applied role. In addition to threatening the delivery of planned outcomes for the limb, pin site infection poses a considerable burden on the patient and on the frame service delivering their care.

How the patient and their carers interact with the pin site environment will impact the likelihood of complications and hence the success of their treatment. There are therefore multiple areas of potential improvement and questions to be addressed to optimize care.

The 2018 international consensus meeting on fracture‑related infections identified through the Delphi process the management of external fixation hardware in relation to infection prevention as a key area lacking evidence.

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