Acute cutaneous complications and catheter needle colonization during insulin-pump treatment

Forty unselected type I (insulin-dependent) diabetic patients with insulin pumps were examined three times for cutaneous complications and bacterial colonization of their subcutaneous catheter needles. Fifty-eight of the 120 needles were contaminated, 42 of them with Staphylococcus epidermis. Cutaneous complications, i.e, erythema of greater than or equal to 1-mm diam at the needle-insertion site, were seen with similar frequency. Significantly fewer (P less than .001) cutaneous complications and contaminated needles were found when a disinfectant was sprayed on the skin before insertion of the needle. The results indicate that infection along the indwelling subcutaneous needle contributes substantially to cutaneous complications during continuous subcutaneous insulin infusion and that these complications can successfully be prevented by appropriate antiseptic measures.