Avoiding unconscious injection of vial-derived rubber particles during intra-articular drug administration
Objective: Vial coring describes the occurrence of small rubber particles, which are formed by needles when perforating vial stoppers. These particles may be aspirated along with the drug. Unconscious injection of rubber particles may increase the risks associated with intra-articular injections. Th...
| Main Authors: | , , , |
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| Format: | Article |
| Language: | English |
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Elsevier
2021-06-01
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| Series: | Osteoarthritis and Cartilage Open |
| Subjects: | |
| Online Access: | http://www.sciencedirect.com/science/article/pii/S2665913121000273 |
| _version_ | 1818738376611725312 |
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| author | Andreas Hecker Agostino Di Maro Emanuel F. Liechti Frank M. Klenke |
| author_facet | Andreas Hecker Agostino Di Maro Emanuel F. Liechti Frank M. Klenke |
| author_sort | Andreas Hecker |
| collection | DOAJ |
| description | Objective: Vial coring describes the occurrence of small rubber particles, which are formed by needles when perforating vial stoppers. These particles may be aspirated along with the drug. Unconscious injection of rubber particles may increase the risks associated with intra-articular injections. This study aimed to analyze the frequency of this phenomenon and possibilities to avoid its occurrence. Method: 800 vials of 2 mL, filled with sodium chloride, were divided into 4 groups (n = 200 each). Aspiration through the rubber stopper was performed with a 18-Gauge needle and the fluid was ejected onto a 10 μm filter paper through a 18-Gauge needle (group one) and a 23-Gauge needle (group two). In group three a 23-Gauge needle was used for aspiration and ejection. In group four, aspiration was performed using 18-Gauge needles with implemented 5 μm filters. Subsequently, a microscopic analysis of the filter papers was performed. Results: In none of the 800 specimen, a rubber particle was detected by naked eye. Microscopically, 20 (10%) rubber particles were detected in group one, 21 (11%) in group two and 65 (33%) in group three. In group four, no particles were visualized. Conclusion: This study shows the occurrence of rubber particles in 10–33% of the cases, when standard needles are used for the aspiration of drugs. We therefore recommend using industrially prefilled syringes, filter needles or removing the rubber stopper before withdrawing drugs from vials for intra-articular injections. |
| first_indexed | 2024-12-18T01:07:58Z |
| format | Article |
| id | doaj.art-1e41bcf7937b43d9aef512a6af2ed1e4 |
| institution | Directory Open Access Journal |
| issn | 2665-9131 |
| language | English |
| last_indexed | 2024-12-18T01:07:58Z |
| publishDate | 2021-06-01 |
| publisher | Elsevier |
| record_format | Article |
| series | Osteoarthritis and Cartilage Open |
| spelling | doaj.art-1e41bcf7937b43d9aef512a6af2ed1e42022-12-21T21:26:11ZengElsevierOsteoarthritis and Cartilage Open2665-91312021-06-0132100164Avoiding unconscious injection of vial-derived rubber particles during intra-articular drug administrationAndreas Hecker0Agostino Di Maro1Emanuel F. Liechti2Frank M. Klenke3Corresponding author.; Department of Orthopaedic Surgery and Traumatology, Inselspital, Bern University Hospital, University of Bern, Freiburgstrasse 4, 3010, Bern, SwitzerlandDepartment of Orthopaedic Surgery and Traumatology, Inselspital, Bern University Hospital, University of Bern, Freiburgstrasse 4, 3010, Bern, SwitzerlandDepartment of Orthopaedic Surgery and Traumatology, Inselspital, Bern University Hospital, University of Bern, Freiburgstrasse 4, 3010, Bern, SwitzerlandDepartment of Orthopaedic Surgery and Traumatology, Inselspital, Bern University Hospital, University of Bern, Freiburgstrasse 4, 3010, Bern, SwitzerlandObjective: Vial coring describes the occurrence of small rubber particles, which are formed by needles when perforating vial stoppers. These particles may be aspirated along with the drug. Unconscious injection of rubber particles may increase the risks associated with intra-articular injections. This study aimed to analyze the frequency of this phenomenon and possibilities to avoid its occurrence. Method: 800 vials of 2 mL, filled with sodium chloride, were divided into 4 groups (n = 200 each). Aspiration through the rubber stopper was performed with a 18-Gauge needle and the fluid was ejected onto a 10 μm filter paper through a 18-Gauge needle (group one) and a 23-Gauge needle (group two). In group three a 23-Gauge needle was used for aspiration and ejection. In group four, aspiration was performed using 18-Gauge needles with implemented 5 μm filters. Subsequently, a microscopic analysis of the filter papers was performed. Results: In none of the 800 specimen, a rubber particle was detected by naked eye. Microscopically, 20 (10%) rubber particles were detected in group one, 21 (11%) in group two and 65 (33%) in group three. In group four, no particles were visualized. Conclusion: This study shows the occurrence of rubber particles in 10–33% of the cases, when standard needles are used for the aspiration of drugs. We therefore recommend using industrially prefilled syringes, filter needles or removing the rubber stopper before withdrawing drugs from vials for intra-articular injections.http://www.sciencedirect.com/science/article/pii/S2665913121000273Vial coringIntra-articular injectionsFilter needleDrug contaminationForeign body reaction |
| spellingShingle | Andreas Hecker Agostino Di Maro Emanuel F. Liechti Frank M. Klenke Avoiding unconscious injection of vial-derived rubber particles during intra-articular drug administration Osteoarthritis and Cartilage Open Vial coring Intra-articular injections Filter needle Drug contamination Foreign body reaction |
| title | Avoiding unconscious injection of vial-derived rubber particles during intra-articular drug administration |
| title_full | Avoiding unconscious injection of vial-derived rubber particles during intra-articular drug administration |
| title_fullStr | Avoiding unconscious injection of vial-derived rubber particles during intra-articular drug administration |
| title_full_unstemmed | Avoiding unconscious injection of vial-derived rubber particles during intra-articular drug administration |
| title_short | Avoiding unconscious injection of vial-derived rubber particles during intra-articular drug administration |
| title_sort | avoiding unconscious injection of vial derived rubber particles during intra articular drug administration |
| topic | Vial coring Intra-articular injections Filter needle Drug contamination Foreign body reaction |
| url | http://www.sciencedirect.com/science/article/pii/S2665913121000273 |
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