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Your insertion sites are red. You wonder if you did something wrong during site preparation or insertion, and you wonder what you should you do about it now and do differently next time.
First of all, change the site to a different location, and be sure always to do careful cleaning and site preparation.
Where do the infection-causing bacteria come from? Typical sources include your hands, the skin at the insertion site, and your own breath. Other organisms can make contact with insertion set equipment from countertops and any other surface areas.
What Are the Signs and Symptoms of Infection?
Symptoms of serious infections include difficulty breathing, malaise, fever or chills.
A minor infection may appear as a small red, tender area at the needle or cannula insertion site. It may clear with daily soap and water cleansing and a topical antibiotic recommended by your physician.
A more serious infection could lead to an abscess or cellulitis. Fungus infections also can develop when sites have been maintained for longer than the recommended duration.
An abscess is a “pocket” of infection that forms at the site of insertion (injury). It is usually filled with pus. The red, painful and swollen skin surrounding the abscess feels warm to the touch, and it may feel as if there is a lump under the skin. An abscess often requires incision and drainage of the infected site, and some infections require treatment with antibiotics. Warm, moist compresses applied to the area will likely be recommended. Insertion sites in the infected area must be avoided for several days or weeks.
Cellulitis is an infection of the underlying layers of the skin, usually involving a greater area of inflammation than an abscess. There may or may not be a lump under the reddened area.
Staphylococcus aureus is the most common bacteria to cause site infections, but other organisms can also cause serious infections such as bacteremia (bloodstream infection). If you are a “carrier” of S. aureus, you should consider wearing a mask to cover your mouth and nose during site preparation and insertion.
Remember, always use proper hygiene, follow good practices for site prep and insertion and be on the lookout for any signs of trouble. When it comes to site infections, like so many things, prevention is the best medicine.
Tips for Preventing Infection
Careful preparation of insertion sites should include washing hands thoroughly with soap and warm water and using antiseptic cleansing solution for the skin.
Placing a sterile protective barrier over the cleaned site before set insertion is sometimes recommended.
Skin cleansing products include IV Prep, Betadine solutions or Hibiclens. A two- to three-inch area around the intended insertion site should be cleaned and allowed to dry.
Avoid touching any part of any equipment that will touch or enter the skin: the needle or cannula tip, the end of the cartridge or reservoir, infusion set connections or the cleaned top of the insulin bottle.
Carefully follow the directions for set insertions and site rotations recommended by your pump trainer, physician or pump manufacturer.
Mar 1, 2005
Diabetes Health is the essential resource for people living with diabetes- both newly diagnosed and experienced as well as the professionals who care for them. We provide balanced expert news and information on living healthfully with diabetes. Each issue includes cutting-edge editorial coverage of new products, research, treatment options, and meaningful lifestyle issues.