Limb lengthening and reconstruction: How to care for pin and wire sites

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Learn how to change your child's dressing and keep their pin and wire sites clean during limb lengthening or correction. 

Key points

  • If your child has an external fixator, it will be kept in place with pins and wires. 
  • Your child's pin and wire sites (the places where the pins and wires enter the skin) will be covered with a dressing. You will learn how to change the dressing before your child leaves the hospital. 
  • Contact your child's health-care team if you notice any pus, swelling, warmth or pain around the sites. These could indicate an infection.

If your child has an external fixator, such as a Taylor Spatial Frame or a monolateral rail, it will be attached to their limb with pins and wires during surgery. The places where the pins and wires enter the skin are called pin and wire sites. The pin and wire sites have dressings to keep them clean.

When are pin and wire site dressings changed?

A nurse will do the first dressing change two days after surgery. They will also teach you how to change the dressings at home. Some families will be referred to a local community health-care centre for home nurse dressing changes for the first few weeks.

If pin and wire sites are healthy, the dressings only need to be changed once a week when your child goes home from the hospital. If pin sites become infected, the dressings need to be changed more frequently. Depending on their standard practice, different surgeons may recommend changing pin site dressings at different intervals.

Once your child can start showering, their dressings will be removed to allow the pin sites to be cleaned each time they shower. This could mean changing the dressings every day.

You or your child can remove the dressings before or during the shower. If removing the dressings in the shower, there is no need to wear gloves. See the dressing change instructions below for more information.

Checkpoints for pin and wire site care

  • Contact a member of your child's health-care team if you notice pain, redness or yellow/green discharge around a pin or wire site or if your child has flu-like symptoms or fever.
  • Do not let your child pick at the pin or wire sites. The dressings that cover the sites should only be touched during a dressing change.
  • Pin sites are reviewed at your child's follow-up clinic appointments, but routine pin site care is not typically done at these visits.

How do I change my child's pin and wire site dressing?

Tools needed to change the pin site dressingsTools needed to change pin site dressings listed on the left

First, gather the following tools.

  • A clean, plastic tray
  • One cotton swab (for example, Q-tip) for each pin and wire site
  • Gauze swabs
  • Foam dressings (such as Allevyn)
  • Saline solution
  • Clean scissors
  • Tweezers
  • Two pairs of clean, non-latex gloves

Next, follow the steps below.

  1. Wash your hands and put on gloves.
  2. Push the plastic clips that hold the dressings up the wire or pin.

  3. Remove and throw out old dressings.

  4. Remove gloves, wash your hands and put on a clean pair of gloves.
  5. Cut the foam dressing into two squares (each measuring about 2 cm x 2 cm). Cut a slit in each square of the dressing from the midpoint of one side to the centre.

  6. Pour the saline into the plastic tray.
  7. Dip a cotton swab into the saline and clean the pin sites individually. Use one cotton swab per site.
  8. Make sure that the skin can move freely around the pin. If necessary, remove crusts with cotton swabs.
  9. Make sure all sites are dry. If necessary, dry each site with a clean piece of gauze.

  10. First foam
    foam square

    Cover each pin site with two squares of foam dressings. If you are using Allevyn, it goes pink side up.

  11. Push down on the plastic clips to hold the dressings in place.
  12. Remove gloves and wash hands.

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Last updated: August 31st 2015