To date, a standard for pin site care has yet to be identified. Pin site care recommendations are more often based upon clinician preference rather than research findings. Further, there are great variations in recommendations for pin care treatments from clinician to clinician. The nursing and medical literature were reviewed in an attempt to identify a pin site care standard based upon scientific findings. Unfortunately, the research on prophylactic treatment of pin sites is limited. The pin site care protocol recommended by this author is based on pathophysiologic processes involved in the development of pin site infections, as well as information found in the research literature. The recommended protocol includes the following: (a) using normal saline as the cleansing agent; (b) avoiding ointments for postcleansing care; (c) removing crusts; (d) using sterile technique for the hospitalized patient while clean technique is used once the patient is discharged from the hospital; (e) applying dressings to pin sites; and (f) providing pin care three times a day if drainage is present or once daily in the absence of drainage.