Effect of Needle Size and Type, Reuse of Needles, Insertion Speed, and Removal of Hair on Contamination of Joints with Tissue Debris and Hair after Arthrocentesis

Abstract

Joint contamination with hair and tissue debris will be decreased by specific needle insertion techniques. Decreased contamination of joints may reduce the frequency of joint infections after arthrocentesis.

Histological Evaluation of Equine Cadaver Skin Cores Dependent on Needle Type and Skin Preparation Method to Investigate Intramuscular Injection Complications in Horses

“…The 313 incidence of hair fragmentation was highest with 18GM needles, followed by 18G and 314 22G needles in both specimen types, with significant differences between 18GM 315 needles and 22G needles in both specimen types. The expected lower incidence of 316 hair fragmentation using 22G needles versus 18G needles in our study correlates 317 with needle size, as previously described by Adams et al [30], who observed 318 increasing amounts of hair fragments when bigger needle sizes were used. 319 for the paraffin embedded skin cores.…”

“…Connective 221 tissue was observed most frequently in 14/16 (87.5%) samples, followed by stratum ratio of hair fragmentation, when using identical needle-and specimen types, as 235 described in a preceding study performed by Adams et al [30]. We cannot explain the 236 variation of the quantity and incidence of skin coring or hair fragmentation in this 237 study.…”

Risk of septic arthritis after intra‐articular medication: a study of 16,624 injections in Thoroughbred racehorses

“…[17][18][19] Injections were performed in open, unbedded stalls in the clinic and although these areas were steam cleaned and disinfected daily, through traffic of horses and personnel may have been substantial. Although there are no definitive evidence-based guidelines regarding the need for clipping or shaving the hair before arthrocentesis in horses, there is limited evidence that hair removal is unnecessary and in fact may be contraindicated when open-ended disposable needles are used.…”

Approach to the Septic Joint

“…The author frequently uses dexmedetomidine (5 μg/kg) and either nalbuphine (0.5 mg/kg) or butorphanol (0.1 mg/kg) intravenously for dogs without any cardiac disease but numerous other sedation protocols are equally effective. The current standard is to clip the hair over the arthrocentesis site and perform a sterile preparation of the skin, although the literature shows that clipping should not be done before arthrocentesis in horses and a similar study has yet to be done in dogs [8]. Arthrocentesis should be performed using sterile technique and a 20-to 25-gauge hypodermic needle of appropriate size.…”

“…Previous diagnostic arthrocentesis, therapeutic intra-articular injections, or a penetrating articular injury can also introduce bacteria and therefore cause articular infection [8][9][10][11]. Furthermore, articular invasion from an adjacent, localized soft-tissue infection or osteomyelitis is possible so any evidence of periarticular infection should create concern for intra-articular involvement [12,13].…”