Recommendations in the use of insulin infusion with the Novalab website.
puncture place:
Preferably the entire surface of the abdomen avoiding the area close to the navel and areas that can be uncomfortable (belts, etc.) Other areas such as buttocks or thighs are acceptable.Suggest the user to put the cannula always in front of a mirror to increase the field of vision and therefore the surface to be chosen.
Also the place that is chosen can be conditioned by the site where you want to take the pump (in your pocket, in the socks, in a fannyry, in the belt, in the braces of the bra, etc.)
In any case it is essential to change the puncture place every time!The rotation of the chosen site should not coincide with any other used area.
The cannula change must always be done every three days or before if for some concrete reason it is convenient for the user.In pregnant women, at least during the last weeks, the change should be every two days.
Cleaning:
Daily hygiene is usually enough!However, more security is desired, an antibacterial product can be used during washing, such as doctodermis solution (C.N.950204).
If a more specific disinfection is required, it is better to use 1% chlorhexidine than alcohol, to avoid the irritating effect of the latter and also achieve residual protection.For example, a little crystalline, solution (C.N.787358) can be used for example,
Always clean the area with a spiral movement from inside out without rubbing.In any case, the area must be completely dry at the time of placing the cannula.
Dissensitization of the area:
It is convenient with some young users and children.A simple approach can be the use of ice.Ice cubes are placed in a bag and keep a few minutes (4 or 5, if it endures) on the area where the cannula will be inserted.You can also serve contact with a metal teaspoon previously cooled in the freezer.
The use of a topical anesthetic based on lidocaine alone or combined is effective.EMLA CREAM (C.N. 679290) used according to its prospect is extremely effective.It must be applied an hour before puncture and the area must be isolated with some type of dressing.The use of 5% lidocaine ointments is a more practical alternative, but currently in Spain there is no preparation with this composition.Another possibility is the use of aerosol with the product, such as Xilonibsa Aerosol (C.N. 868166);4 or 5 sprays are applied to the area to click and a few minutes are expected to act and dry.Its effect is lower, but enough on many occasions.
In all cases the area must be completely clean of prepared and dry at the time of placing the cannula.
Adhesion problems:
If there are adhesion problems because the adhesive of the cannula is frequently detached, various solutions can be arbitrated in an isolated or combined way.
If there is an important sweating, it is usually convenient to treat the next puncture site with some antitranspirant, such as some ointment of the “Prote Sud” type (C.N. 339390).Its application must be suspended about 6 hours before the puncture.
The use of an adherent on the skin can help, but also a few times to carry hypersensitivity problems.We recommend the use of “Skin Tac” wipes (they can be supplied by Novalab).Additionally, an adherent solution as “Nobecuta” (C.N. 795252) can also be pulverized, on the cannula adhesive, but never on the central plastic of it.
If it is valued useful, a tape on the cannula already adhered can also be placed,Although it is always adding one more glue on the skin.
The use of a dressing with good adhesion ("Tegaderm HP") can be the alternative in the most extreme cases, better using a double dressing in a "sandwich or paired" on the infusion game.The technique would be: on the area where the infusion game is to be placed, an impregnated with the “Skin-Tac”, a “Tegaderm HP” is placed, and the infusion game is applied to it.A second dressing "Tegaderm HP" bends in four and the upper corner is cut so that when applying it leaves a hole to save the head of the infusion game, and sticks so that the infusion game is "matched" between theTwo dressings.
Aposits:
The use of surgical types such as TegaderMHP (3m products) or OP-Site IV 3000 (Smith & AMP product; NEPHEW) can be useful in certain circumstances.The most recommended size for our purpose is 6 x 7 cm.These dressings can be supplied by Novalab in the aforementioned size.
The dressings are of necessary choice in cases of hypersensitivity to the adhesive of the infusion cannulas and can be useful in case of frequent infections, having a barrier effect.
The dressings are of doubtful utility as a remedy to greater adherence due to excessive sweating, perhaps with the exception of TegaderMHP.
withdrawal from the cannula:
Once the cannula has been removed, you have to properly clean the area where it was placed as recommended before insertion.Previously if they are remains of adhesive they can be removed with a little bath oil.
Once the area is cleaned on the point where the cannula was inserted, a small amount of ointment can be applied to stimulate the healing, as a scar (C.N.729517).
With a little care we will avoid in most cases that marks on the skin with the consequent effect on its aesthetics and health.
Sporadic infections:
Occasionally and with less incidence of what is thought, a small infection can occur in the puncture site.If redness of the area is observed, local fever, or pus point in the area where the cannula is inserted, it must be changed to another area immediately.The new cannula will be placed at a sufficiently distant point of the previous one, extreme hygienic measures.
The infected point will be treated following a common protocol.If there is a small divides or a grain it is advisable to burst it.Some topical antibiotic according to medical prescription will be applied.If after 48 hours the continuous infection, consult with the doctor.
Frequent infections:
If the appearance of infections at the cannula insertion occurs with a certain frequency, as a first alternative it is convenient to verify the degree of monitoring of the hygienic measures in the placement and withdrawal of the cannula.If the skin was not disinfected, it will be necessary to do it.It can be tested as a Povidone Iodada disinfectant, Betadine Hydroalcoholic (C.N. 725606) instead of chlorhexidine, being also effective against mycobacteria.Also propose the systematic use of a dressing as a barrier.
If the situation persists, send the user to the dermatology service for study, valuation and specific guideline.
General considerations:
We must always observe, as usual in daily practice, minimal precautions.Before recommending any product of those indicated here, it is necessary to make sure that the user has not previously had adverse reactions with any of its components.
The products mentioned or similar will be used according to the guidelines indicated in the corresponding prospect.
We must instruct the user so that beforeThe slightest suspicion of some unwanted effect with any of these products suspends its use.
The constancy and perseverance by the user in always following the recommended guidelines is important, so it is convenient to review his practice from time to time.
