Recommendations
for Pin Care: Avoiding Infection
by Dr. Nancy Romer (patient and psychologist)
Keeping your pin sites infection-free is probably the most important
job you have during your recovery. If you do a great job keeping yourself
infection-free (and if your body cooperates with you), you'll have
an easier and less painful time of it.
The first thing to be aware of is that each pin site is its own open
wound and must never share germs with another pin site. This means
never use an applicator (6-inch Q-tip), paper towel, or any other
cleaning implement from one pin site to the next.
This is what I do and it's worked pretty well so far:
1) The shower
Take a daily shower and make sure that you have a
hose with which to wash yourself. I use an 80-inch hose purchased
from Home Depot attached to a showerhead. We purchased a "diverter"
which, with the flick of a switch, will funnel water either into the
new showerhead with the 80" hose or through the original showerhead.
Use your favorite soap on the rest of your body, but only use Dial
Anti-Bacterial soap in a pump bottle on your pin sites. Point the
shower hose directly on the pin sites (front and back of the frame),
then pump Dial soap directly on to each pin site. Do not touch the
pin site with the hose or the pump bottle; just the soap and water.
Thoroughly hose off the soap with the clean water. That will get rid
of most of the dead skin and thoroughly clean the pin sites. Make
sure all the soap residue is removed by the shower hose. Cleaning
your pin sites should be the last thing you do in the shower so that
any other residue from the rest of your shower that might have fallen
on the pin sites will have been cleaned. I use a clean washcloth to
dry the area around the pin sites and the frame, but never touch the
pin sites themselves. Let them air dry.
2) Cleaning with hydrogen peroxide
Do this on a bed or in a place where you can comfortably sit with
your leg up for a half hour. Have all of your pin care materials and
implements in a container next to you. Mix equal amounts of hydrogen
peroxide and sterile water in a clean paper cup (use a different paper
cup each day). Use sterile 6" cotton-tipped applicators (long one-sided
Q-tips). You'll probably use about 15 packs each cleaning. Take three
or four of the packages, strip them of the paper packaging and dip
them into the mixture of peroxide and sterile water. Take one applicator
and use it to clean one pin site. Clean all around the pin site and
throw the applicator away. You will probably need two or three applicators
for each pin site to do a good job. Don't forget to clean the full
length of the pin itself. Any excess dead skin or other debris should
be removed. NEVER USE THE SAME APPLICATOR ON MORE THAN ONE PIN SITE
OR YOU WILL SPREAD POTENTIAL INFECTION. Repeat this with each of the
pin sites. Note: I have used sterilized toothbrushes (a different
brush for each pin site) for particularly hard-to-get-to or infected
pin sites. Make sure to buy only soft toothbrushes and to brush the
pin site gently but firmly enough to clean it thoroughly. Don't forget
to sterilize each toothbrush before each cleaning in boiling water
and alcohol. Dip each sterilized toothbrush into the peroxide and
sterile water mixture only once. When you are finished cleaning each
of the pins, take the left over mixture and pour it directly onto
the pin sites. Dry each pin site with a sterile applicator -- never
use the same applicator for drying more than one pin site. Use a hair
dryer with a low temperature to further dry the pin sites. Make sure
the hair dryer does not touch the pin sites. Dry the pin sites front
and back.
3) Anti-biotic ointment
Use triple anti-biotic pain relief ointment (Neosporin, or better
yet, a generic copy that each pharmacy chain has) to keep your pin
sites bacteria-free yet moist. Dry, cracked skin around the pin sites
can be very painful. Apply about 1/4 of an inch of the ointment with
a sterile applicator on to each pin site. Again, only use one applicator
on one pin site. Make sure that the whole pin site is covered by the
ointment.
4) Xeroform Petrolatum Dressing
This is another product that can help you keep your pin sites clean
and moist. The gauze dressing comes in a long, folded rectangle. Purchase
a scissors specifically meant to cut gauze which can be purchased
at a pharmacy specializing in surgical supplies for about $7 (regular
scissors will not work). Also purchase two tweezers. Sterilize the
scissors and tweezers each day by boiling in water for 10 minutes
and then cleaning them with rubbing alcohol. Cut out about a square
inch of gauze from the rectangle. Hold it with the sterilized tweezers,
not your fingers. Make a diagonal cut 2/3s of the way into the gauze
square. Using the two tweezers, place the gauze on your pin site with
the diagonal cut around the pin. Do not touch the pin site directly
with the tweezers.
5) Kerlix Bandage (This only applies to monolateral frames,
not the circular frames)
At last, you are ready to finish off the job. Use a fresh Kerlix bandage
each day. Wrap the Kerlix bandage around the outside of the pins until
you've used the entire Kerlix bandage. Make sure the bandage is close
to and covering the Xeroform gauze. This bandage is further protection
to keep your pin sites clean.
Note for swimmers: If you swim in chlorinated water, either
use the shower in the locker room (plus Dial soap) for your daily
cleaning and then continue with the rest of the pin care. If you can't
do the full pin care as described above, pour some hydrogen peroxide
and sterile water mixture on the pin sites and cover with a fresh
Kerlix bandage; do the rest of the pin care at home.
Building Your Immune System
While pin care is the most important factor preventing infection,
how your body responds to infection is important too. I take lots
of vitamins (a multi-vitamin, an additional 1500 mg of C and Kyolic
garlic extract) to boost my immune system. I also drink a cup of fresh-squeezed
orange juice daily. Don't forget to take at least 1500 mg of calcium
each day to help support bone growth. I also take a combination of
arginine and ornithine as well as symphytum officinale to foster bone
growth.
Where to Purchase Less Expensive Pin Care Materials
Kerlix Bandages
Life-Assist, Inc
800-824-6016
http://www.life-assist.com
http://www.life-assist.com/ba/bn.html
$1.98 a bandage
Cotton Tipped Applicators
http://www.bardpaper.com
$3.00 a box for 200 applicators
Xeroform Petrolatum Gauze Dressing
21st Century Medical
1-877-217-8633
http://www.21stcenturymedical.com/
box of 5 x 9" strips for $95.00 (50 strips)
box of 1 x 8" strips for $63.00 (50 strips)
Symphytum Officinale (Boiron)
(Bone Trauma Promotes Healing of Fractures)
http://www.theBetterHealthstore.com
877-876-8247 $4.31 each
Neosporin (with Pain Reliever) costs about $8.00.
The generic from Rite-Aid or CVS or other chains is about $3.65.
|