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Lean and Green Hand Surgery: Evaluating the Sterility of Stored Corticosteroid Injection Preparations Using
Harmon S Khela1, Bijan Dehghani1, Ana Sofia Rive2
1University of Pennsylvania, Philadelphia, USA.
Hand (New York, N.Y.)
|June 17, 2026
Summary
Predrawn corticosteroid injections prepared aseptically show low contamination rates up to two weeks. This supports extending their use, reducing waste and costs in hand surgery.
Area of Science:
- Hand surgery
- Sterile preparation techniques
- Microbiology
Background:
- Corticosteroid injections are frequently used in hand surgery and often pre-drawn for efficiency.
- Routine discarding of unused syringes, despite aseptic preparation, leads to significant waste due to contamination concerns.
Purpose of the Study:
- To assess the microbiologic sterility of stored corticosteroid-lidocaine injections.
- To evaluate the feasibility of extending the use of pre-drawn injections beyond same-day administration.
Main Methods:
- Sterile corticosteroid-lidocaine injections were prepared aseptically.
- Syringes were stored at room temperature and tested for bacterial DNA using next-generation sequencing (NGS) at various time points up to 2 weeks.
- Primary endpoint was detection of bacterial DNA on the needle or in the fluid.
Main Results:
- Ninety-seven-five percent (97.5%) of experimental samples tested negative for bacterial DNA.
- Only one fluid sample showed contamination with a Streptococcus species at 1 week.
- Positive controls confirmed assay sensitivity for polymicrobial contamination.
Conclusions:
- Aseptic preparation of corticosteroid injections results in a low contamination rate over a 2-week storage period.
- Extending the use of pre-drawn injections can reduce waste, lower costs, and promote sustainability in hand surgery.
- Findings support revised protocols for pre-drawn injection use.
