Pressure generated by syringes: implications for hydrodissection and injection of dense connective tissue lesions

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Title Pressure generated by syringes: implications for hydrodissection and injection of dense connective tissue lesions
Author Hayward, W.A.P.; Haseler, Luke Jonathon; Kettwich, L.G.; Michael, A.A .; Jr, W.L. Sibbitt; Bankhurst, A.D.
Journal Name Scandinavian Journal of Rheumatology
Year Published 2011
Place of publication United Kingdom
Publisher Informa Healthcare
Abstract Objective: Hydrodissection and high-pressure injection are important for the treatment of dense connective tissue lesions including rheumatoid nodules, Dupuytren’s contracture, and trigger finger. The present study determined the optimal syringes for high-pressure injection of dense connective tissue lesions. Methods: Different sizes (1, 3, 5, 10, 20, and 60 mL) of a mechanical syringe (reciprocating procedure device) with a luerlock fitting were studied. Twenty operators generated maximum pressure with each mechanical syringe size, and pressure was measured in pounds per square inch (psi). Subsequently, 223 dense connective tissue lesions were injected with different sizes of syringes (1, 3, or 10 mL). Outcomes included (i) successful intralesional injection and (ii) clinical response at 2 weeks. Results: Smaller syringes generated significantly more injection pressure than did larger syringes: 1 mL (363 197 psi), 3 mL (177 96 psi), 5 mL (73 40 psi), 10 mL (53 29 psi), 20 mL (32 18 psi), and 60 mL (19 12 psi). Similarly, smaller syringes were superior to larger syringes for intralesional injection success: 10 mL: 34% (15/44) vs. 1 mL: 100% (70/70) (p < 0.001) and 3 mL: 91% (99/109) (p < 0.001). Conclusion: Smaller syringes ( 3 mL) are superior to larger syringes ( 5 mL) for successful hydrodissection and highpressure intralesional injection of dense connective tissue lesions.
Peer Reviewed Yes
Published Yes
Alternative URI http://dx.doi.org/10.3109/03009742.2011.560892
Volume 40
Issue Number 5
Page from 379
Page to 382
ISSN 0300-9742
Date Accessioned 2012-03-05; 2012-03-09T05:31:56Z
Date Available 2012-03-09T05:31:56Z
Research Centre Griffith Health Institute; Heart Foundation Research Centre
Faculty Griffith Health Faculty
Subject Cardiovascular Medicine and Haematology
URI http://hdl.handle.net/10072/43497
Publication Type Journal Articles (Refereed Article)
Publication Type Code c1

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