The Sterility of Partially Used Hyaluronic Acid Fillers After Long Storage

Abstract

Although it is commonly practiced, the storage of HA fillers after initial patient injection carries a real but small risk of contamination.

Review of sterility of reused stored dermal filler

“…The remaining two microbiological studies that examined hyaluronic acid products showed growth of skin/oral flora in less than 15% of the samples . The main organism detected was S epidermidis followed by Corynebacterium species , Bacillus species , Staphylococcus oralis , and Diphtheroids . Immediate replacing needles used in injection with a sterile substitute before storage was associated with no growth in one study and growth in another study .…”

“… Four out of the six microbiological studies that examined hyaluronic acid products showed no growth, using aerobic, anaerobic, and/or fungal culture media . The remaining two microbiological studies that examined hyaluronic acid products showed growth of skin/oral flora in less than 15% of the samples . The main organism detected was S epidermidis followed by Corynebacterium species , Bacillus species , Staphylococcus oralis , and Diphtheroids .…”

“…The main organism detected was S epidermidis followed by Corynebacterium species , Bacillus species , Staphylococcus oralis , and Diphtheroids . Immediate replacing needles used in injection with a sterile substitute before storage was associated with no growth in one study and growth in another study . There was no reported infection in the only patient‐based study that examined the adverse events among patients injected with stored hyaluronic acid filler syringes…”

“…The details of the included studies are shown in Table . Seven of the nine studies examined hyaluronic acid products while two studies examined collagen fillers . Few samples of calcium hydroxylapatite were included in one study .…”

“…Although it is not recommended, if partially used syringes to be stored for future use in the same patients, a number of precautions should be carefully followed to minimize the risk of contamination. These include the use of good skin preparation before injection using long‐lasting germicidal such as both alcohol and povidone iodine but not only 70% which does not have significant residual activity after evaporation . The stored syringes should not be stored at room temperature but rather in a refrigerator.…”