To date, there remains a lack of evidence concerning the optimal treatment for pin-site care [
5,
11,
12]. The peri- and postoperative management of the pin sites shows a high variability [
1,
8]. It is still hard to find a uniform standard that describes how to deal with the pin sites (after application and removal of the fixator extern). There is no consent in preventing pin-site infections, which is reflected in the many hospitals which have different postoperative pin-site care protocols [
13]. In one of the most frequently cited publications about pin-site care of an external fixator, a literature review examines the infection rate in terms of pin design, surgical technique, cleaning solutions, frequency of pin-site cleaning, dressing types, effect of showering, and antibiotic prophylaxis [
4‐
6,
14,
15]. In this paper, the treatment of the pin sites after removal of the external fixator is not considered in detail so it is unclear what method leads to a reduction of infections and wound-healing problems. In the authors’ department, after removal of the external fixator, the pin sites are routinely treated by primary wound closure. However, a recently published international survey showed that the majority of surgeons treated the pin site by secondary wound healing [
15]. In a review paper, Kazmers et al. discussed different influencing factors for infections of the pin site. Therefore, it is unknown whether the pin design, the surgical technique, different disinfection solutions, the frequency of pin-site cleaning, the dressing type or the choice of antibiotics is important for pin-site infections [
14]. In order to address the postoperative management of the pin site, this prospective, randomized controlled trial has been designed. This trial should determine whether the pin sites should be left open or can safely be closed after removal of the external fixator with respect to the occurrence of postoperative wound infection.
This study has some limitations which should be acknowledged. Firstly, this is a single-center study. Although this might make the results less generalizable, single-center studies tend to have more complete data and loss loss-to-follow-up, thus improving the data quality. Secondly, although the study population size is sufficient for detecting differences in primary outcome, it is not large enough for in-depth subgroup analysis.