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[Skin fragments carried by spinal needles in cadavers]
M A Reina1, A López, F Manzarbeitia
1Servicio de Anestesiología y Reanimación, Hospital General de Móstoles, Madrid.
Revista Espanola De Anestesiologia Y Reanimacion
|November 1, 1995
Summary
Certain needles used for epidural or intradural injections can transfer skin cells into the spinal canal, potentially causing epidermoid cysts. Touhy needles showed a higher rate of cell transport compared to Quincke and Sprotte needles.
Area of Science:
- Neurosurgery
- Anesthesiology
- Medical Device Engineering
Context:
- Lumbar punctures, including epidural and intradural procedures, carry a risk of introducing foreign material.
- Improperly handled needles can lead to the transport of epithelial cells or skin fragments into the spinal canal.
- Such cellular introduction may result in the formation of epidermoid cysts, a rare but serious neurological complication.
Purpose:
- To evaluate the cell and epithelial fragment transport capabilities of various needles commonly used in epidural and intradural procedures.
- To compare the cell transport efficiency between different needle types (Touhy, Quincke, Sprotte) and gauges.
- To identify potential risks associated with specific needle designs and manufacturers in the context of spinal procedures.
Summary:
- A study involving 120 needles across six groups (Touhy G-16, Touhy G-17, Quincke G-22, Quincke G-26, Sprotte G-22, Sprotte G-24) examined cell transport during simulated lumbar punctures on cadavers.
- Epidermal cells or skin fragments were identified in solutions used to wash the needles post-insertion.
- Touhy G-16 needles showed the highest rate of tissue transport (45%), followed by Touhy G-17 (30%). Quincke G-22 (15%) and Sprotte G-22 (30%) also demonstrated cell transport.
- Significantly more tissue was transported by Touhy needles compared to Quincke (p < 0.01) and Sprotte (p < 0.05) needles.
Impact:
- Findings indicate that specific needle types, particularly Touhy needles, have a higher propensity to transport epithelial fragments during lumbar punctures.
- Highlights the need for enhanced quality control in the manufacturing of epidural and intradural needles.
- Suggests that improved manufacturing standards could mitigate the risk of rare neurological complications arising from epithelial cell deposition within the spinal canal.