Current trends in needle-free jet injection: an update

Barolet, Daniel; Benohanian, Antranik

doi:10.2147/ccid.s162724

Cited by 70 publications

(82 citation statements)

References 59 publications

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“…The jet‐injector was first invented in France in 1860 and works by forcing a stream of liquid through a precision nozzle which creates a liquid jet that can penetrate the skin and the subcutaneous tissue . Through the mid 20th century, these needle‐free‐injections were extensively used, worldwide, as insulin self‐injectors as well as for mass‐vaccination programs . The injections were often spring‐controlled and intended for subcutaneous or intramuscular delivery.…”

Section: Introductionmentioning

confidence: 99%

“…The injections were often spring‐controlled and intended for subcutaneous or intramuscular delivery. Treatments were therefore often painful, and associated bruising, infections, and neuropathy . Due to retrograde flow and splash‐back, the risk of contamination was high, and in 1997, the U.S. Department of Defense, which was the biggest utilizer of the technique, discontinued jet‐injection vaccinations due to the reports of cross‐contamination .…”

Section: Introductionmentioning

confidence: 99%

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Needle‐Free Injection Assisted Drug Delivery—Histological Characterization of Cutaneous Deposition

2019

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Background and Objectives: Many cutaneous drugdelivery techniques rely on passive diffusion to deliver topical compounds to the skin. When attempting to deliver drugs to thicker lesions, such as skin tumors, modalities that do not rely on diffusion may serve as a better drug-delivery method. In this histological study, we aim to investigate the cutaneous delivery patterns of an electronic pneumatic needle-free injection device. Study Design/Materials and Methods: Needle-freeinjection was investigated in 24 ex vivo porcine skin samples and one basal cell carcinoma (BCC) tissue sample. A needle-free injection device with a nozzle size of 200 μm delivered 80 μl compound ink (0.1 cc black ink: 5.0 cc saline) at low (30%/3.1 bar; n = 6 porcine skin; n = 1 BCC tissue), medium (50%/3.9 bar; n = 6 porcine skin), high (65%/4.6 bar; n = 6 porcine skin), and stacked (30 + 50%/3.1 + 3.9 bar; n = 6 porcine skin) pressures. Depth, width, and depth of maximum width of ink deposition were evaluated on histological slides. Results: Depositions with small ink-lined vacuoles were seen intra-dermally in all samples, including the BCC tissue. Deposition depth was similar at low and medium pressures (924 vs. 994 μm; P = 0.873) but increased significantly with high pressure (1,564 μm; P = 0.010). When injections were stacked (3.1 + 3.9 bar), the depth remained similar to that of a single injection (931 μm; P = 1.000). The width of the deposition stayed comparable for low, medium, and high pressures when a single needlefree injection was performed (30% = 2,394 μm; 50% = 2,226 μm; and 65% = 2,757 μm; P = 0.09), but increased significantly with stacking (2,979 μm; P = 0.037). The depth of maximal width was superficially located in the papillary dermis at low and medium pressures (321 and 305 μm; P = 0.748) but shifted to the deeper reticular dermis with high pressure (950 μm; P = 0.004) and with stacking (734 μm; P = 0.004). Conclusions: In conclusion, with an electronically controlled, pneumatic needle-free injector, depth and width of a cutaneous deposition can be influenced by pressure and stacking, respectively. The pneumatic needle-free injection can potentially serve as a viable drug-delivery technique for cutaneous pathologies where dermal deposition is essential. Lasers Surg. Med.

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Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Needle‐Free Injection Assisted Drug Delivery—Histological Characterization of Cutaneous Deposition

2019

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“…Fast liquid jets carry spatially confined kinetic energy that can penetrate into a tissue 2 . Motivation for this work ranges from the development of needle-free transdermal drug injectors [3][4][5][6][7][8][9] , "liquid scalpel" for soft tissue dissecting [10][11][12] or devices for gene delivery [13][14][15] . The main advantage lies in the smaller extent of collateral damage caused to the tissue, superior lateral precision and addressability of certain depths 16 .…”

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confidence: 99%

Repetitive regime of highly focused liquid microjets for needle-free injection

Krizek

Delrot

Moser

2020

Sci Rep

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fast liquid jets are investigated for use as a needle-free drug delivery system into an elastic tissue such as skin. Using smaller jet diameters in a repetitive regime can mitigate bruising and pain associated with current injectors. in this study, we aim to unravel the potential of the method to deliver liquids into biological tissues having higher elasticity than healthy skin (i.e >60 kPa). To address this challenge, we have implemented a laser-based jetting system capable of generating supersonic liquid microjets in a repetitive regime. We provide insights on the penetration of microjets into hydrogel samples with elastic modulus ranging from 16 kPa to 0.5 MPa. The unprecedented speeds of injection (>680 m/s) together with a newly introduced repetitive regime opens possibilities for usage in needle-free drug administration into materials with elasticity covering the wide spectrum of biological soft tissues like blood vessels, all skin layers, scarred or dried skin or tumors.Development of needle-free delivery systems for distribution of medicines was listed as one of the grand challenges in global health 1 . The goal is to reduce contaminated waste, mitigate the risk of disease spreading or to avoid needle-stick accidents. Fast liquid jets carry spatially confined kinetic energy that can penetrate into a tissue 2 . Motivation for this work ranges from the development of needle-free transdermal drug injectors 3-9 , "liquid scalpel" for soft tissue dissecting 10-12 or devices for gene delivery [13][14][15] . The main advantage lies in the smaller extent of collateral damage caused to the tissue, superior lateral precision and addressability of certain depths 16 .The use of currently available jet injectors is associated with pain and bruising which originates from the relatively large injection depth and volume 4 . This can be addressed by injecting smaller diameter jets in repetitive regime thus compensating for the smaller volume of each jet by its multiplicity. In the context of needle-free drug delivery, this strategy was first implemented by Arora 4 using a piezo actuator system 17 . The Arora study 4 showed that in vivo injection in rats minimized the collateral damage and provided sufficient dosage of insulin. The same technology was used by Römgens et al. 3 who reported a delivery efficiency through the first skin layer (epidermis) as high as 90%. Jets were mostly stopped by the reticular dermis and reached the hypodermis with the efficiency of only 12%. With regard to the diagram presented by Rodríguez et al. 18 we can claim, that such shallow penetration prevents this technology from delivering a drug aimed to reach the hypodermis or muscle tissue.

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“…A local penetrating dose of steroid into the digit has been reported to be administered using a needle or high‐pressure jet from tools, such as porto‐jet or dermo‐jet, previously. Needleless injecting instruments have the potential disadvantage of splash‐back of blood onto the instrument and practitioner, and development of epidermoid implantation cysts after porto‐jet therapy has also been reported 16 . Moreover, these instruments have a potential 20% to 30% loss of steroid dose because of back‐flow, and some instruments are very expensive 4 .…”

Section: Discussionmentioning

confidence: 99%

Intralesional triamcinolone injections for the treatment of nail dystrophy: A case series

Yoo

Bang

Han

et al. 2020

Dermatologic Therapy

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Nail dystrophy can be temporary or permanent and affects quality of life for many patients. It can be secondary to an inflammatory condition; however, many cases are idiopathic. Despite many efforts, there is no promising treatment. Local steroid injection is one of the standard therapies offered for nail dystrophy, but there have been few formal open trials or case reports of its efficacy. This study investigated the impact of intralesional triamcinolone injections on the management and safety of nail dystrophy. Overall, 12 patients with 55 nails affected by nail dystrophy were enrolled. All lesions were injected with triamcinolone acetonide (2.5 mg/mL, 0.1 cc) through the proximal nail fold with a 30 g needle. Injections were administered every 4 weeks. Efficacy was retrospectively evaluated using physician's global assessment of clinical photographs graded on a 5‐point scale as 0, no improvement; 1, slight improvement; 2, moderate improvement; 3, marked improvement; and 4, almost resolved. All adverse events that occurred during treatment were recorded. All patients presented with slight improvement of nail dystrophy after 1 to 3 months. The treatment durations varied from 6 to 12 months (mean, 8.58 months). The average time to observed therapeutic effect was 1.91 months after first treatment. The mean outcome assessment score was 2.8 points, with two patients each showing slight and moderate improvement and five showing marked improvement; in three, the dystrophy was almost resolved. Side effects of this regimen were minimal. Intralesional triamcinolone injections are an effective and safe method for the treatment of nail dystrophy.

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Current trends in needle-free jet injection: an update

Cited by 70 publications

References 59 publications

Needle‐Free Injection Assisted Drug Delivery—Histological Characterization of Cutaneous Deposition

Needle‐Free Injection Assisted Drug Delivery—Histological Characterization of Cutaneous Deposition

Repetitive regime of highly focused liquid microjets for needle-free injection

Intralesional triamcinolone injections for the treatment of nail dystrophy: A case series

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