Maximizing extraction of botulinum toxin type A from vials.
OBJECTIVE
To determine the residual botulinum toxin remaining in vials after using 3 different extraction methods and to analyze the different techniques for measuring extraction efficacy.


METHODS
Multicentered comparative study.


METHODS
Three academic movement disorder clinics.


METHODS
Thirty physicians were randomly surveyed for their botulinum toxin extraction methods. Three physicians evaluated the most common methods.


METHODS
Not applicable.


METHODS
Amount of toxin left in vials after each extraction method.


RESULTS
Toxin was least successfully extracted by using the vial inversion method. More toxin was extracted by using the 2-in needle method. The top removal method produced the least waste of toxin but is considered unsafe.


CONCLUSIONS
The best and safest method for consistently extracting the most botulinum toxin from its vial was to use a long 21-gauge 2-in needle attached to a 3-mL syringe.
Dykstra
Dennis D
DD
Department of Physical Medicine and Rehabilitation, University of Minnesota, Minneapolis, MN 55455, USA. dykst001@maroon.tc.umn.edu
Wieting
J Michael
JM
McGuire
John
J
Kowalkowski
Thomas
T
D019274:Botulinum Toxins, Type A / Q000008:administration & dosage*; D004339:Drug Compounding / Q000379:methods / Q000706:statistics & numerical data; D004349:Drug Packaging / Q000379:methods* / Q000706:statistics & numerical data; D006801:Humans; D007273:Injections, Intramuscular / Q000295:instrumentation / Q000379:methods* / Q000706:statistics & numerical data; D009339:Needles; D009465:Neuromuscular Agents / Q000008:administration & dosage*; D010818:Practice Patterns, Physicians' / Q000706:statistics & numerical data; D013396:Suction / Q000295:instrumentation / Q000379:methods* / Q000706:statistics & numerical data; D011795:Surveys and Questionnaires; D013594:Syringes; D014481:United States
D009465:Neuromuscular Agents; D019274:Botulinum Toxins, Type A