Needle-free jet injection-induced small-droplet aerosol formation during intralesional bleomycin therapy
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Needle-free jet injection-induced small-droplet aerosol formation during intralesional bleomycin therapy. / Bik, Liora; Wolkerstorfer, Albert; Bekkers, Vazula; Prens, Errol P.; Haedersdal, Merete; Bonn, Daniel; van Doorn, Martijn B. A.
I: Lasers in Surgery and Medicine, Bind 54, Nr. 4, 04.2022, s. 572-579.Publikation: Bidrag til tidsskrift › Tidsskriftartikel › Forskning › fagfællebedømt
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TY - JOUR
T1 - Needle-free jet injection-induced small-droplet aerosol formation during intralesional bleomycin therapy
AU - Bik, Liora
AU - Wolkerstorfer, Albert
AU - Bekkers, Vazula
AU - Prens, Errol P.
AU - Haedersdal, Merete
AU - Bonn, Daniel
AU - van Doorn, Martijn B. A.
PY - 2022/4
Y1 - 2022/4
N2 - Objectives Needle-free jet injectors are frequently used in dermatological practice. Injection-generated small-droplet aerosols could be harmful upon inhalation when chemotherapeutics, like bleomycin, are used. Here, we aim to explore jet injector-induced small-droplet aerosol formation of bleomycin in relation to air ventilation and to provide safety measures for clinical practice. Materials and Methods With a professional particle sensor, we measured airborne aerosol particles (0.2-10.0 mu m) after electronic pneumatic injection (EPI), spring-loaded jet injection (SLI), and needle injection (NI) of bleomycin and saline (100 mu l) on ex vivo human skin. Three levels of air ventilation were explored: no ventilation, room ventilation, and room ventilation with an additional smoke evacuator. Results EPI and SLI induced significant small-droplet aerosol formation compared with none after NI (0.2-1.0 mu m; no ventilation). The largest bleomycin aerosol generation was observed for the smallest particles (0.2-1.0 mu m) with 673.170 (528.802-789.453) aerosol particles/liter air (EPI; no ventilation). Room ventilation and smoke evacuation led to a reduction of >= 99% and 100% of measured aerosols, respectively. Conclusion Jet injectors generate a high number of small-droplet aerosols, potentially introducing harmful effects to patients and healthcare personnel. Room ventilation and smoke evacuation are effective safety measures when chemotherapeutics are used in clinical practice.
AB - Objectives Needle-free jet injectors are frequently used in dermatological practice. Injection-generated small-droplet aerosols could be harmful upon inhalation when chemotherapeutics, like bleomycin, are used. Here, we aim to explore jet injector-induced small-droplet aerosol formation of bleomycin in relation to air ventilation and to provide safety measures for clinical practice. Materials and Methods With a professional particle sensor, we measured airborne aerosol particles (0.2-10.0 mu m) after electronic pneumatic injection (EPI), spring-loaded jet injection (SLI), and needle injection (NI) of bleomycin and saline (100 mu l) on ex vivo human skin. Three levels of air ventilation were explored: no ventilation, room ventilation, and room ventilation with an additional smoke evacuator. Results EPI and SLI induced significant small-droplet aerosol formation compared with none after NI (0.2-1.0 mu m; no ventilation). The largest bleomycin aerosol generation was observed for the smallest particles (0.2-1.0 mu m) with 673.170 (528.802-789.453) aerosol particles/liter air (EPI; no ventilation). Room ventilation and smoke evacuation led to a reduction of >= 99% and 100% of measured aerosols, respectively. Conclusion Jet injectors generate a high number of small-droplet aerosols, potentially introducing harmful effects to patients and healthcare personnel. Room ventilation and smoke evacuation are effective safety measures when chemotherapeutics are used in clinical practice.
KW - aerosol
KW - bleomycin
KW - chemotherapy
KW - dermatology
KW - droplet
KW - drug delivery
KW - injection
KW - jet injection
KW - pneumatic
KW - ventilation
KW - TRIAMCINOLONE ACETONIDE
KW - ALOPECIA-AREATA
KW - DERMOJET
KW - SCARS
KW - ACID
KW - DRUG
U2 - 10.1002/lsm.23512
DO - 10.1002/lsm.23512
M3 - Journal article
C2 - 34931319
VL - 54
SP - 572
EP - 579
JO - Lasers in Surgery and Medicine
JF - Lasers in Surgery and Medicine
SN - 0196-8092
IS - 4
ER -
ID: 314437531