PURPOSE: There is no evidence based consensus or protocol for the most effective pin site care regimen for patients treated with external fixators. Whilst the Royal College of Nursing recommends regular weekly pin site care, actual practice varies greatly across the UK and wider world. The aim of this study was to survey healthcare professionals and patients to ascertain the variety of pin site care regimens used across the UK. METHODS: Patients and healthcare professionals from limb reconstruction units were surveyed on current pin site care approaches. Two surveys, exploring specifics of pin site care regimens were created with expertise from the British Limb Reconstruction Society Research committee and circulated to the membership and patients. RESULTS: 60 healthcare practitioners responded along with 53 patients, demonstrating significant variation in pin site regimen in both cleaning frequency, solution used and dressing type applied. No consensus was noted nationally, between regions / hospitals, or even in some cases within units. CONCLUSIONS: This study demonstrates a lack of evidence base and variation in pin site practice across the NHS. We recommend a future multicentre trial to inform new guidance on the most clinical and cost-effective pin site care regime.