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ORIGINAL ARTICLE
Year : 2022  |  Volume : 8  |  Issue : 1  |  Page : 84-87

Hydrosurgical debridement of Grade VI external fixator pin site infection


Department of Surgical Sciences, Division of Orthopaedic Surgery, Faculty of Medicine and Health Sciences, Stellenbosch University, Stellenbosch, South Africa

Correspondence Address:
Aaron Kumar Saini
Department of Surgical Sciences, Division of Orthopaedic Surgery, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, Stellenbosch 7505
South Africa
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/jllr.jllr_6_22

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Background: Pin site infection is a common complication with external fixation, with a reported incidence of 26%–71% in the context of limb reconstruction. The Checketts and Otterburn (C&O) classification is frequently used, with minor infections (C&O I–III) treated with pin site care and enteral antibiotics. Major infections (C&O IV–VI) require removal of the infected pin or fine wire. Surgical debridement is indicated where the infection persists following pin removal (C&O grade VI). The Versajet hydrosurgery system (Smith & Nephew, Memphis, Tennessee) utilizes a saline jet to debride biological tissue. Methods: A retrospective review was conducted on all patients who underwent Versajet hydrosurgery debridement with C&O grade VI pin site infections between January 2011 and January 2021. Data regarding patient demographics, fixator type, indication for the initial surgery, and treatment outcome were recorded. Results: The cohort comprised seven males (87.5%) and one female (12.5%) with a mean age of 41.4 years ± 17.74 (range 16–61). Mean follow-up was 11.8 months ± 6.2 (range 7–25). The mean time in external fixator was 155 days ± 85.19 (range 83–354), and the mean time between fixator removal and Versajet debridement was 46 days ± 33.83 (range 3–116). No perioperative complications were experienced, and all patients (n = 8, 100%) were found to be infection-free at the last clinical review, with healed overlying soft tissue. Conclusion: The Versajet hydrosurgical debridement system is effective in managing C&O grade VI pin site infections. The method is reproducible and provides long-term clearance of infection, allowing subsequent soft tissue healing.


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