So how can we reduce bruising from injections?

Reduce trauma

Ensure your positioning and placement as the injector is comfortable and stable. Starting from the bottom at the feet, equal weight distribution will help with this, you can lean against the bed or coach to also stabilise the upper body if this is comfortable and feels right. Good manual dexterity and confident needle control and needle/syringe grasp should also be of the highest measure. An experienced injector will pay attention to the positioning of the whole body, not just the obvious areas like the hands and needle tip.

ADDITIONAL TAKE AWAYS

• Stabilise arm below elbow
• Stabilise hand at wrist or below
• Feel confident to use bed, patients’ shoulder, forehead or cheek as stabilisation
• Ensure patients head is reasting against the bed to resist the force of injecting hand, reducing depth of penetration

Make sure needles are always sharp

Changing the needle during the procedure, after it has been used a few times, will reduce bruising as with every injection the needle will become more and more blunt, in turn causing heightened pressure and trauma to the tissues. Superficially skin is much tougher than under the epidermal layer. Penetrating the needle 1-2mm round the eyes for example should be sufficient the deliver the product adequately, while avoiding the lower venous plexus. Slow and careful withdrawal is also key. Immediate pressure should be given to any obvious areas of bleeding on needle withdrawal

Adapting technique to include the use of a cannula, or not withdrawing the needle fully in a fanning technique, will reduce the amount of penetration sites whilst still enabling cover and delivery of the filler over a couple of sites or areas.