Orthopaedic Surgery - How to care for your pin sites (Kurgan method)

How to clean your pin sites

You will be shown how to clean your pin sites whilst you are in hospital.

You will need:

• Soap and water to wash your hands
• Dressing pack
• Extra packs of non-woven gauze
• 600ml bottle of Pink Hydrex Chlorhexidine, (Chlorhexidine gluconate 0.5% in isopropyl, alcoholic solution 70%) product code: 407283 in Unichem catalogue)
• Sterile scissors/clean scissors
• A tray or a table ONLY to be used for preparation and organisation of dressing products

You will be given a supply of items you need to clean your pin sites when you leave hospital. When you need more supplies, please obtain them from your GP.

You will be given a letter for your GP listing the items.

Cleaning your pin sites:

Keep pets and young children out of the room while you are cleaning your pin sites.

Handwashing is the best way to prevent bugs or infections spreading from your hands to your pin sites.

1.    Wash hands

• Wash hands using soap and water and dry thoroughly
• Clean your tray/table

2.    Prepare your tray/table so you can start your dressing:

• Open the dressing pack: unfold the edges of the pack, being careful NOT to touch the inside area and contents - so NOT to contaminate them
• Open extra packs of gauze and place on the open dressing pack area/field
• Pour the PINK HYDREX into the small plastic pot - if unavailable use a plastic container which has been thoroughly cleaned and rinsed with boiled water
• Have clean scissors to hand (for cutting pin site dressings/ gauze)
• Put on NON-STERILE gloves (if you have them) and remove all your old dressings. Dispose of these in a plastic bag.

3.    Wash your hands again

• Apply STERILE GLOVES - touching only the inside wrist end as you apply them

4.    Clean each pin site separately:
You are now ready to clean and dress your pin sites:

• Soak the gauze swabs in Pink Hydrex and squeeze out until damp. Then leave these for 5 minutes prior to using/applying them to allow some of the alcohol to evaporate, this will sting less. Clean each pin/wire with an individual piece of this gauze
• Start at the pin entry site and work up and away towards the outer edge of the frame.

5.    Crusts around the pin entry site are to be left in place, providing the pin site remains free from infection. If there are any signs of infection the crusts need to be removed to allow drainage.

Some patients may be allergic/sensitive to Hydrex which may produce a rash. If this happens, please use normal saline (salt water) to clean your pins and cover with dry gauze.

• Do not take the gauze back towards the pin site once you have cleaned the wire.

6.    Dressing of the pin site:
Cut a slit/or a “Y” shape hole in the gauze dressing. Y-shape for pins. Slit for wires.

• Place the soaked gauze with the “Y” shape/ slit around the pin (see diagram)
• The gauze is held in place by bungs/clips (clips are available from clinic). If there is a lot of drainage/oozing, please apply a foam dressing instead of gauze. If your pin site is irritated or infected* please clean with saline and dress with inadine and gauze/foam dressing.

7.    Repeat the above procedure for each pin site

8.    If there is no oozing from your dressings, do not change for 7 days.

Signs of pin site infection

• Each seven days repeat the cleaning and dressing procedure as described above, unless there is any:
• Increased pain
• Redness
• Heat
• Pus
• Temperature
• Your leg becomes stiff
• You are feeling unwell
• If so, it is very important that you contact the doctor or nurse at the hospital, or your GP as soon as possible, in case you have an infection and may require antibiotics.

If you develop a pin site infection, you will need to clean the infected pin daily or even twice a day. If you develop a cavity (hole) around the pin site you will need to clean it with salt water, not Pink Hydrex (saline).

If you are prescribed antibiotics for a pin site infection please enter the information on the table on page 8 of this leaflet and bring this to clinic with you, every visit. This allows us to keep track of any pin site infections being treated or recurring problems.

Discharge

You will be seen by the doctor and nurse in the orthopaedic outpatient clinic 1-2 weeks after discharge.

General information

• You cannot shower the leg and frame, until your wounds are healed and have been checked by the doctor or nurse at your first outpatient appointment
• You can still shower your body if you cover your leg and frame with a plastic bag. This should be sealed with tape at the top, so no water can get in
• When you are told by the doctor or nurse that your wounds are healed, you may shower your leg and frame on the day you need to clean your pin sites
• Following your shower, you may find it easier to dry your frame with a hairdryer (on a cool setting)

Pin site infections and treatment

Useful contact numbers

Lynn Adams - Specialist Nurse
Clinic - 0161 206 4894/Pager - 07623 621 293 (Phone 0161 789 7373 and ask to be connected to the pager)

Amanda Redfern - Associate Specialist Nurse
Clinic - 0161 206 4894/Bleep – 5152 (via switchboard 0161 789 7373) Monday to Friday 9.00am to 4.00pm

Orthopaedic Treatment Rooms - 0161 206 4894
Plaster Room - 0161 206 4900
Orthopaedic Outpatient Clinic - 0161 206 4902
Ward B5 - 0161 206 4600
Ward B6 - 0161 206 4574
Ward H4 - 0161 206 4578
Physiotherapy Gym - 0161 206 1090
Mr Wilkes & Khunda secretary number is 0161 206 1234
Mr Sprott secretary number is 0161 206 5830
Mr Rafee secretary number is 07749 722474