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Calm, irritated or infected? The experience of the inflammatory states and symptoms of pin site infection and irritation during external fixation: A grounded theory study

Santy-Tomlinson, Julie; Vincent, Maria; Glossop, Nicola; Pearcey, Patricia; Jomeen, Julie

Authors

Julie Santy-Tomlinson

Maria Vincent

Nicola Glossop

Patricia Pearcey

Julie Jomeen



Abstract

Aim.  To explore patients' experiences of the symptoms of suspected wound infection in external fixator pin sites. Background.  Pin site infection is painful and distressing and can threaten the success of treatment. It is difficult for patients and clinicians to differentiate between pin site infection and irritation or foreign body reaction to the pin. There is no validated outcome measure for infection that enables the success of interventions for prevention and management to be evaluated. There is a need to develop accurate patient-orientated assessment criteria. Design.  Qualitative design, using grounded theory. Method.  Following written informed consent, a theoretical sample of 16 adults with an external fixation device that had been in situ for at least 12 weeks was recruited. They had experienced a pin site infection in the previous four weeks. Data were collected using semistructured interviews, and data collection was stopped when saturation was achieved. Analysis took place using constant comparative analysis. Results.  Participants described three 'clinical states' of pin site wounds: calm, irritated and infected. They described the differences in each state in relation to pain, redness, swelling, discharge and general symptoms. Symptoms were absent or varied in intensity depending on whether the pin sites were calm, irritated or infected. Conclusion.  This study provides insight into patients' experiences of the symptoms of pin site infection resulting in an emerging theory based on conceptualisation of this experience, which is that of dimensions of inflammatory pin site states. The detail given will enable clinicians and researchers to be more accurate in recognising infection and begins to clarify the difference between a wound that is irritated and a wound that is infected. The findings will enable the development of a patient-orientated outcome questionnaire for pin site infection. Relevance to clinical practice.  There is a need for patients and clinicians to be able to differentiate between infected, not infected and irritated pin sites.

Citation

Santy-Tomlinson, J., Vincent, M., Glossop, N., Pearcey, P., & Jomeen, J. (2011). Calm, irritated or infected? The experience of the inflammatory states and symptoms of pin site infection and irritation during external fixation: A grounded theory study. Journal of clinical nursing, 20(21-22), 3163-3173. https://doi.org/10.1111/j.1365-2702.2011.03805.x

Journal Article Type Article
Acceptance Date Apr 3, 2011
Online Publication Date Aug 11, 2011
Publication Date 2011-11
Deposit Date Nov 13, 2014
Journal Journal Of Clinical Nursing
Print ISSN 0962-1067
Electronic ISSN 1365-2702
Publisher Wiley
Peer Reviewed Peer Reviewed
Volume 20
Issue 21-22
Pages 3163-3173
DOI https://doi.org/10.1111/j.1365-2702.2011.03805.x
Keywords General Nursing; General Medicine
Public URL https://hull-repository.worktribe.com/output/462932
Publisher URL https://onlinelibrary.wiley.com/doi/abs/10.1111/j.1365-2702.2011.03805.x
Contract Date Nov 13, 2014