title: Sterility of stored nonanimal, stabilized hyaluronic acid gel syringes after patient injection.
abstract: BACKGROUND
  Restylane (Restylane; Q-Medical, Uppsala, Sweden) is a nonanimal stabilized hyaluronic acid (NASHA) that has become increasingly popular for soft tissue augmentation and volume correction because of its greater longevity and lower rate of hypersensitivity reactions when compared with collagen. Despite manufacturer warnings, the remaining material in the syringe is commonly stored for subsequent treatment in the same patient.
  
  
  OBJECTIVE
  Our purpose was to determine the incidence of bacterial contamination of NASHA stored after initial patient injection.
  
  
  METHODS
  After use of a specific sterile sequence, NASHA from previously used syringes stored at room temperature for 2 to 9 months was cultured under aerobic (n = 20) and anaerobic conditions (n = 10).
  
  
  RESULTS
  No bacteria were cultured from any of the samples.
  
  
  CONCLUSIONS
  Limitations of this study include sample size and storage period for a maximum of 9 months.
  
  
  CONCLUSIONS
  NASHA remaining in syringes after patient injection was not contaminated with bacteria. Our study raises the possibility that re-use of the remaining portion of material in the syringe may be safe and is more economical than discarding it.
authors.affiliation: Maryland Laser, Skin and Vein Institute, Hunt Valley, Maryland 21030, USA.
authors.forename: Supriya G
authors.initials: SG
authors.lastname: Bellew
authors.forename: Karen C
authors.initials: KC
authors.lastname: Carroll
authors.forename: Margaret A
authors.initials: MA
authors.lastname: Weiss
authors.forename: Robert A
authors.initials: RA
authors.lastname: Weiss
mesh_terms: D001419:Bacteria / Q000302:isolation & purification*; D004340:Drug Contamination; D005782:Gels; D006820:Hyaluronic Acid / Q000031:analogs & derivatives*; D010865:Pilot Projects; D013242:Sterilization; D013594:Syringes
chemical_list: D005782:Gels; D006820:Hyaluronic Acid; C445361:Restylane