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External Fixation Hand & Wrist Surgery
What is External Fixation?
External fixation is a technique used to help heal severely broken bones. This type of orthopedic treatment involves securing the fracture with a specialized device called a fixator, which is external to the body. Using special bone screws (commonly called pins) that pass through the skin and muscle, the fixator is connected to the damaged bone to keep it in proper alignment as it heals.
How Do I Care For My Fixator Pin Sites Properly?
It is important to take care of your fixator and the pin sites to help prevent an infection from developing. In addition to other complications, an infection may require removal of the device, which can interfere with proper healing.
Depending on the type of external device you have and the severity of your injury, your hand and wrist surgeon may recommend different cleaning techniques or cleansing solutions. Always wash your hands thoroughly before you clean your skin and the device. Be gentle and meticulous, making sure everything is dried carefully. You should repeat this cleaning process at regular intervals even if you are taking prescribed antibiotics to prevent infection.
Gather all the supplies you will need — Your pin sites and the device need to be cleaned twice daily, so it makes sense to get all of the supplies you will need and store them in a location that is dry and easily accessible. You will need:
- Clean towels
- Sterile water
- Hydrogen peroxide solution
- Disposable cups
- Sterile cotton swabs
- Sterile gauze pads
- Small trash bag for discarded materials
Gently cleanse around the pin sites — First, wash and dry your hands, discarding the towel afterward. Then, gently stimulate the skin around the pins to bring drainage to the surface. Using a cotton swab dipped in a diluted (50/50) peroxide saline solution, clean each pin site. Gently move the swab in a circular motion going outward from the site. Always use a new swab when you switch sites.
Clean the pins — Clean each pin with a gauze pad. You may be required to wrap gauze around each pin site until there is no more drainage.
Carefully clean the fixator device — Use a combination of cotton swabs and gauze pads to clean all parts of the device. When you are done, throw out all cleaning materials and wash/dry your hands.
Take a shower — After about seven to ten days, it may be possible to shower with your device (always follow your doctor’s orders). After showering, dry the device with a clean towel and cleanse the pin sites as instructed in the steps above.
If you have any questions about how to properly clean and care for your device, talk with your doctor.
What Are Symptoms of Infection I Should Look For?
Infection is always a risk, regardless of how thorough your home care regimen is. Do not hesitate to contact your doctor as soon as possible if you notice these signs of infection:
- Swelling or redness at the pin site
- Colored or thick discharge
- Pain
- Tenderness
- Any movement (however slight) in the pins