There has been little research comparing rates of infectious complications between buried and percutaneous Kirschner wire (K-wire) use in hand trauma surgery. The additional cost of removing buried wires should be justified by a demonstrable reduction in the frequency and/or severity of infectious complications. We prospectively collected data on infective complications associated with K-wire use during the course of 1 year at our hand trauma unit. We observed seven (10%) infections in 70 patients where wires were left protruding and three (9%) infections in 34 patients where wires were buried. There was no statistically significant difference in the rate of infectious complications. A cost analysis was performed, taking into account infectious complications and the cost of their management. Burying K-wires resulted in an extra cost of £235.51 per patient compared to £90.80 per patient for percutaneous K-wires. Thus, the use of buried K-wires results in a £144.71 increase in cost per patient. Clinicians should consider these findings, as well as other (medical) considerations, when making the decision whether to bury K-wires.
European Journal of Plastic Surgery – Springer Journals
Published: Nov 1, 2012
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