Needle-Free Jet Injectors and Their Potential Applications in Plastic Surgery: A Review

Needle-free jet injector (NFJI) devices offer an alternative to traditional needle-syringe injection for administration of medications, vaccines, and other fluids. They are already in clinical use around the world for vaccines and insulin administration. NFJIs have reproducibly demonstrated improvement in speed of drug absorption and efficacy; however, this technology has yet to prevail in the plastic surgery industry. Plastic surgeons have experimented with this technology to inject botulinum toxin for palmar hyperhidrosis, steroids for keloids/hypertrophic scars, and local anesthesia. A review was conducted to identify studies published in the last 10 years, indexed on PubMed, involving NFJI devices. Original articles that included ex vivo experimentation, animal studies, and human trials were included. Review articles, mathematical modeling theoretical articles, and nonmedical applications of jet injectors were excluded. A total of 767 identified articles were screened. Once exclusion criteria were applied, there were 115 articles remaining. The majority of the studies were conducted on human patients (n = 62, 53.9%), followed by ex vivo, small, and large animal models. Subcategories of investigations included device efficacy, mechanics, safety, and patient preferences. In conclusion, NFJI are a viable, safe, and potentially more efficacious delivery system compared with traditional needle-syringe techniques for the delivery of medications, vaccines, and other injectable fluids. Patient preference and pain were improved with NFJI. These devices have significant potential clinical applications in the plastic and dermatologic fields.