Stoffel C, Eltz B, Salles MJ. Role of coatings and materials of external fixation pins on the rates of pin tract infection: A systematic review and meta-analysis. World J Orthop 2021; 12(11): 920-930 [PMID: 34888152 DOI: 10.5312/wjo.v12.i11.920]
Corresponding Author of This Article
Mauro José Salles, MD, MSc, PhD, Assistant Professor, Medical Assistant, Professor, Musculoskeletal Infection Group, Internal Medicine Department, Santa Casa de São Paulo School of Medical Sciences, Rua Dr Cesáreo Mota Jr 112, Paulo 01221-020, Brazil. salles.infecto@gmail.com
Research Domain of This Article
Orthopedics
Article-Type of This Article
Meta-Analysis
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
World J Orthop. Nov 18, 2021; 12(11): 920-930 Published online Nov 18, 2021. doi: 10.5312/wjo.v12.i11.920
Role of coatings and materials of external fixation pins on the rates of pin tract infection: A systematic review and meta-analysis
Cristhopher Stoffel, Bruno Eltz, Mauro José Salles
Cristhopher Stoffel, Department of Orthopedic Surgery, Instituto de Ortopedia e Traumatologia do Rio Grande do Sul, Passo Fundo 99010110, Rio Grande do Sul, Brazil
Bruno Eltz, Department of Orthopedic Surgery, Hospital São Francisco, Concordia 89700-000, Santa Catarina, Brazil
Mauro José Salles, Musculoskeletal Infection Group, Internal Medicine Department, Santa Casa de São Paulo School of Medical Sciences, São Paulo 01221-020, Brazil
Mauro José Salles, Musculoskeletal Infection Group, Division of Infectious Diseases, Escola Paulista de Medicina, Universidade Federal de São Paulo, São Paulo 01221-020, Brazil
Author contributions: All authors contributed to the conception or design of the work, or the acquisition, analysis, or interpretation of data for the work; Stoffel C and Salles MJ contributed the drafting the work or revising it critically for important intellectual content, and agreement to be accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved; all authors have read and approved the final manuscript.
Conflict-of-interest statement: All authors declare that they have no competing interests.
PRISMA 2009 Checklist statement: The authors have read the PRISMA 2009 Checklist, and the manuscript was prepared and revised according to the PRISMA 2009 Checklist.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Mauro José Salles, MD, MSc, PhD, Assistant Professor, Medical Assistant, Professor, Musculoskeletal Infection Group, Internal Medicine Department, Santa Casa de São Paulo School of Medical Sciences, Rua Dr Cesáreo Mota Jr 112, Paulo 01221-020, Brazil. salles.infecto@gmail.com
Received: April 21, 2021 Peer-review started: April 21, 2021 First decision: July 28, 2021 Revised: August 6, 2021 Accepted: October 8, 2021 Article in press: October 8, 2021 Published online: November 18, 2021 Processing time: 209 Days and 3.5 Hours
ARTICLE HIGHLIGHTS
Research background
Few clinical studies assessed the impact of pin materials and coating systems on infection rates over the last 20 years.
Research motivation
Few studies identified significant differences between pin materials in the rate of infection. There has been a lack of standardized criteria for defining and grading pin tract infection of external fixators.
Research objectives
Search the literature of the last 20 years for evidence on the influence of coating systems and different materials of external fixator pins on infection rates.
Research methods
A systematic review was carried out, over the last 20 years, according to the preferred reporting items for systematic reviews and meta-analyses guidelines in the following databases: PubMed, LiLacs, SciELO and Cochrane.
Research results
Seven studies met the inclusion criteria and allowed for three different meta-analyses between similar coating systems and materials used. Due to the heterogeneity of the studies, it was not possible to carry out a meta-analysis that encompassed all selected works.
Research conclusions
Currently, no significant clinical benefit to control infection rates has been achieved with our coating pins systems.
Research perspectives
Prospective multicenter clinical trials involving pin materials and new coating systems should be carried out.
