Metal pins are used to apply skeletal traction or external fixation devices in the management of orthopaedic fractures. These pins protrude through the skin and are therefore described as 'percutaneous' and much has been written on the management of the associated skin wound. The way in which percutaneous pins are treated may affect the incidence of pin site infection. Recommendations for care are not necessarily evidence based. This review set out to summarise the research evidence on the effect of pin site care on infection rates.