Pins and wires are necessary components of limb lengthening, deformity correction and external fixation. The purpose of pin/wire site care is to keep the interface of the pin (or wire) and skin free from bacteria and to prevent trauma to the skin. Keeping the skin clean helps prevent infection. Pin/wire site care is done weekly and increased to daily if there are signs of inflammation or infection. Pin/ wire site care should follow any showering, bathing or swimming. (Do not shower, bathe or swim until your sutures are removed and you have been seen for your postoperative visit). 

Pin/ wire site care will be done in the hospital on the first or second postoperative day. You will review site care at this time and will be given supplies for home, which will include: 

Supplies

• Sterile cotton-tipped applicators
• Sterile normal saline
• Hydrogen peroxide (use half-strength by mixing half hydrogen peroxide and half normal saline during pin/wire site infections)
• Sterile specimen containers
• Sterile 2” x 2” split gauze squares (SOF-SICK* l.V. Sponges 2” x 2” - y ply)
• Foam squares with nylon backing (for Ilizarov fixator-pin/wire sites)
• Custom-cut felt strips (for Orthofix fixator pin sites)

Instructions

1. Wash hands thoroughly with Dial (or other antibacterial soap) for at least one minute, us¬ing nailbrush, prior to pin/ wire site care.
2. Push up the red/white plastic clips on the pin/wire (red clips on pins and white clips on wires for Ilizarov fixators; Orthofix fixators do not have clips). 
3. Remove foam sponges (felt pads with Orthofix) and gauze dressings. You may soak the difficult, encrusted ones with normal saline or run clear water over the site until they loosen. Slowly “teasing” the sponge off causes less pain and bleeding. 
4. Inspect all sites for redness, tenderness and drainage. If the sites are clear, normal saline can be used for cleaning. If signs of infection are present, half-strength hydrogen peroxide should be used. 
5. Put several cotton-tipped applicators in normal saline and allow to soak for several seconds.
6. Take one applicator and use a rolling motion to apply gentle pressure with cotton tip at junction of skin and pin/ wire site. Do not use excessive force, but remove the scab.
7. Once the site is cleaned, you may clean the site of the pin or wire if needed. Do not use the same applicator on the skin that you use to clean the pin and/ or wire. 
8. Use a new application at each site. 
9. Cover the site with a split 2” x 2” gauze, followed by foam sponge and plastic clip (for Ilizarov fixators), and felt pad over gauze (for Orthofix fixators). You may reuse the sponges by cleaning them with soap and water, then boil them for one minute and allow to air dry. 
10. Compress the clip, sponge and gauze gently (excessive pressure may cause indentation of skin, especially if swelling is present.