Free Nursing Dissertations - All Wound Sites Were Washed With An Iodine Solution And Covered With Dry
All wound sites were washed with an iodine solution and covered with dry gauze and infection was monitored through pain reports, swelling, redness and the number of pathogenic bacteria obtained through culture sampling with the pin sites. It was found that 92% of infections were due to one particular type of bacteria that was responsive to oral antibiotics. Infections occurred amongst 25% of patients in the saline group, 18% of the alcohol group and 8% of the no-cleaning group. The infection rate was 35% higher in the femoral than tibial pins, and wound sites near the groin or thighs were particularly vulnerable to infection. This study included a small sample of patients, but the researchers had not reported if patients were balanced at baseline for anatomical distribution of pin sites since this could have been an important factor in subsequent risk of infection irrespective of the cleaning regime employed. Furthermore, inferential statistics were not attempted in this study. Other studies have suggested different cleaning regimes using hydrogen peroxide, saline or sterile water. There are also differences in the timing of infection cleaning from daily to weekly to fortnightly, and dressing or leaving the wound site exposed. Furthermore, there is a lack of consensus amongst research studies about whether scabs at the pin sites should be left untouched, or removed, and whether massage should be used to promote drainage of exudates. The systematic reviewers conclude that, there is a complete absence of evidence for any particular strategy of pin site care. Adequately powered randomised controlled trials are required to examine the effectives of different pin care regimes (Temple and Santy, 2004, p 5). Temple and Santy (2004b) have considered pin site management, as addressed through two research studies. They once again introduce the research study by Henry that was included in the Cochrane review, but also include a research study by Sproles (1984). This research study was a quasi-experimental investigation of pin site infection over 9 months. The study introduced the Sproles’ tool for monitoring skin infection. However, Temple and Santy (2004) argue that the validity of the Sproles’ tool must be questioned in the context of currently recognised good practice. The validity issue in question here relates to whether the tool is really measuring or testing what we think it is measuring (that is the rate or incidence of pin site infection/ reaction) and whether it is sensitive enough to identify a clinically significant infection from one that is not (p 133). This was not a randomised study, so patients were recruited and assigned by convenience sampling. This introduced the risk of a range of biases’ that influence the reliability of the research outcomes and representativeness of research conclusions.
