Therapeutics and Clinical Risk Management (Oct 2022)
Using a Double Syringe Sterile System for MSK Aspiration/Injection Procedures Eliminates Risk of Iatrogenic Infection
Abstract
Adrian Emil Lazarescu,1– 3 Bogdan Gheorghe Hogea,2– 4 Bogdan Corneliu Andor,2– 4 Alina Totorean,2,5 Dan Grigore Cojocaru,2,3 Marius Negru,6 Laura A Bolintineanu,7 Jenel Marian Patrascu Jnr,2– 4 Liviu C Misca,2– 4 Mihai A Sandesc,2– 4 Jenel Marian Patrascu Snr2– 4 1Department of Anatomy and Embriology, University of Medicine and Pharmacy “victor Babes” Timișoara, Timisoara, Romania; 2 2nd Clinic of Orthopedics and Traumatology, County Emergency Hospital “Pius Branzeu” Timisoara, Timisoara, Romania; 3Profesor Teodor Sora’ Research Center, University of Medicine and Pharmacy “Victor Babes” Timișoara, Timisoara, Romania; 4Department of Orthopedics and Traumatology, University of Medicine and Pharmacy “Victor Babes” Timișoara, Timisoara, Romania; 5Department of Medical Recovery, University of Medicine and Pharmacy “Victor Babes” Timișoara, Timisoara, Romania; 6Department of Pediatric Surgery, University of Medicine and Pharmacy “Victor Babes” Timișoara, Timisoara, Romania; 7Department of Pathophysiology, University of Medicine and Pharmacy “Victor Babes” Timișoara, Timisoara, RomaniaCorrespondence: Bogdan Gheorghe Hogea, Tel +40744363188, Email [email protected]: Diverse musculo-skeletal pathology can be treated conservatively by different types of injections and in most cases, results are significantly better if the existing inflammatory fluid is aspirated prior to injection of medication solutions. The present study analyses an original technique which uses infusion therapy accessories to create two types of closed sterile double syringe systems, and compares the benefits of using such a system in aspiration/injection procedures to classic aspiration injection technique that implies changing and connecting multiple syringes to the same needle, thus increasing the risk for septic complications. The aim of the present study is to minimize therapeutic risk of iatrogenic septic complications during aspiration/injection procedures.Methods: 1024 patients underwent aspiration/injection procedures in our clinic using the double syringe system between 2015 and 2020. During the early stages of the study, the second type of assembly was rendered impractical so the study continued with analyzing a single type of double syringe system using a three way infusion therapy device which is readily available, and allows the assembly of a closed sterile system with a single, two-step procedure technique. Iatrogenic local septic complications were followed by means of a six week clinical follow-up evaluation with additional investigations only if necessary.Results: In 1024 procedures we report 0% incidence of iatrogenic septic complications, or other types of complications and recommend this technique in a vast array of rheumatic, orthopedic or traumatic conditions that require aspiration/injection procedures.Discussion: The double syringe system is practical, easy to use, it completely eliminates the risk of iatrogenic infection due to manipulation errors, and significantly simplifies the technique for sonography guided aspiration/injection procedures for musculo-skeletal pathology.Keywords: musculo-skeletal injections, aspiration/injection technique, double syringe system, iatrogenic infection, rheumatology, joint pathology
