Current classifications of pin site infection and quality of reporting: A systematic review

Abstract

Introduction: Pin site infection is a commonly encountered complication. There is no universally accepted definition or classification system which impairs data interpretation and the development of evidence-based practice. The aim of this systematic review is to investigate the existing classification systems and the quality of reporting pin site infections in the current literature. Materials and Methods: The systematic review protocol was prospectively registered (PROSPERO; National Institute for Health Research and University of York, 2015) and conducted using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses. A comprehensive search strategy was executed. Data were extracted pertaining to clinical, radiological, microbiological, and mechanical elements alongside associated grading and demographics. The scope of the classification systems was considered. Results: Twelve reports of classifications were included in the synthesis. Four classifications provide information for guiding decision-making and management while the remainder are descriptive or informative in nature. There is no classification with prognostic inference. Four of the classifications can only be applied retrospectively as they are outcome derived. Staging relies on a single variable in six of the classifications. It relies on multiple variables (maximum of four) in the remainder. Conclusion: There is a lack of a clear definition of pin site infection and a lack of a universally accepted grading system. Existing classifications focus on different aspects and have a number of limitations. Establishing standard reporting guidelines will allow for future development of a meaningful and universally accepted definition and classification.

Keywords

• classification
• definition
• infection
• pin site
• pin track
• scoring
• staging