A Prospective Pilot Cohort Study of Hydrocyn Gel as a Dressing Agent Compared with Conventional Flavin-Based Pin-Site Care for Infection Prevention
Description
Background: Pin-site infection (PSI) is a pervasive complication of external fixation, whose prevention is hampered by a lack of consensus on optimal care. This study aims (a) to generate preliminary estimates of pin-site infection rates associated with Hydrocyn gel compared to conventional flavin dressing and (b) to characterize the pattern and severity of infections (using the Checketts-Otterburn scale) in both groups over a four-week follow-up period. Methods: A prospective cohort study was conducted from April 2024 to December 2025. Sixteen patients with external fixators were included: 10 used Hydrocyn gel and 6 used conventional flavin dressing. Patients in both groups performed self-dressing every three days. Patients were followed weekly for four weeks, with pin-site infection diagnosed and graded using the Checketts and Otterburn scale. Due to the non-randomized design, small sample size, and retrospective trial registration, no inferential statistical tests were performed; results are descriptive. Results: The Hydrocyn gel group had a lower pin site infection rate of 20% (2/10) compared to 66.7% (4/6) in the flavin group. In the Hydrocyn gel group, two patients developed Grade 1 infections; one resolved spontaneously, and one had worsening infection that required surgical debridement and pin removal. The flavin group experienced earlier and more frequent infections, with one patient requiring early debridement and multiple cases progressing to Grade 2 and 3. No osteomyelitis was reported in either group. Conclusion: Hydrocyn gel was associated with a lower observed rate of pin-site infection n compared to conventional flavin dressing in a trauma population. Because treatment allocation was based on patient consent rather than randomization, the observed association between Hydrocyn gel and lower infection rates should be interpreted as hypothesis-generating rather than evidence of treatment efficacy.