The quality of evidence is downgraded by study limitations (unclear allocation concealment and lack of blinding), by inconsistency (variability in results), and by imprecise results (few patients and outcome events).
A Cochrane review included 11 studies with a total of 572 subjects. Three trials compared a cleansing regimen with no cleansing, 3 trials compared alternative sterile cleansing solutions, 3 trials compared methods of cleansing, 1 trial compared daily pin site care with no care, and 6 trials compared different dressings. One small study (n=38) found that the risk of pin site infection was significantly reduced with polyhexamethylene biguanide (PHMB) gauze when compared to plain gauze (RR 0.23, 95% CI 0.12 to 0.44) (infection rate of 1% in the PHMB group and 4.5% in the control group) but this study was at high risk of bias as the unit of analysis was observations rather than patients. There were no other statistically significant differences between groups in any of the other trials.