Journal List > J Korean Acad Nurs > v.40(6) > 1002677

TOOLS
Choi, Sohng, and Kim: Prediction of Optimal Gluteal Intramuscular Needle Length by Skinfold Thickness Measurements in Korean Adults
Original Article
Journal of Korean Academy of Nursing

Journal of Korean Academy of Nursing 2010; 40(6): 844-851.

Published online: 31 December 2010

DOI: https://doi.org/10.4040/jkan.2010.40.6.844

Prediction of Optimal Gluteal Intramuscular Needle Length by Skinfold Thickness Measurements in Korean Adults

Dong-Won Choi1, Kyeong-Yae Sohng2, Bum-Soo Kim3

1Assistant Professor, Red Cross College of Nursing, Seoul, Korea.

2Professor, College of Nursing, The Catholic University of Korea, Seoul, Korea.

3Professor, Department of Radiology, College of Medicine, The Catholic University of Korea, Seoul, Korea.

Address reprint requests to: Sohng, Kyeong-Yae. College of Nursing, The Catholic University of Korea, 505 Banpo-dong, Seocho-gu, Seoul 137-701, Korea. Tel: 82-2-2258-7410, Fax: 82-2-2258-7772, sky@catholic.ac.kr

Received 21 July 2010       Accepted 28 December 2010

Copyright © 2010 Korean Society of Nursing Science

Abstract

Purpose

This study was conducted to assess optimal needle length for gluteal intramuscular injections (IM) via simple skinfold thickness (SFT).

Methods

For this study, 190 healthy adults were recruited and grouped into eight groups according to gender and body mass index (BMI) (kg/m2). The Korean Society for the Study of Obesity criteria defines a BMI under 20 as underweight, 20.1-22.9 as normal, 23-24.9 as overweight and over 25 as obese. For each participant, the SFT of dorsoguteal (DG) and ventrogluteal (VG) sites were measured using a caliper. Subcutaneous tissue thickness was acquired through ultrasonic images.

Results

For men in the overweight and obese groups at the DG site, for the obese group at the VG site, and for women in the normal weight, overweight and obese groups at both sites, the mean subcutaneous tissue thickness exceeded 1.84 cm, the minimal length for a 1 inch needle used for IM. At the DG site, optimal intramuscular needle length (OINL) was 1.4 times in women and 1.0 times in men compared to SFT. At the VG site, OINL was 1.3 times in women and 0.9 times in men compared to SFT.

Conclusion

The results of this study suggest that SFT is a reliable index to determine optimal needle length with minimal effort prior to IM.

Keywords: Intramuscular injection, Buttocks, Skinfold thickness, Ultrasonography, Subcutaneous tissue

Figures and Tables

Figure 1
Axial ultrasonic image of gluteal site.
jkan-40-844-g001
Table 1
Skinfold Thickness, Subcutaneous Tissue Thickness and Optimal Intramuscular Needle Length according to Gender and BMI at Dorsogluteal Site
jkan-40-844-i001

BMI=body mass index; DG=dorsogluteal site; SFT=skinfold thickness; SCT=subcutaneous tissue thickness; *OINL=optimal intramuscular needle length (SCT+0.6 cm); RRIL=rate of reaching intramuscular layer; †OINL/SFT.

Table 2
Skinfold Thickness, Subcutaneous Tissue Thickness and Optimal Intramuscular Needle Length according to Sex and BMI in Ventrogluteal Site
jkan-40-844-i002

BMI=body mass index; VG=ventrogluteal site; SFT=skinfold thickness; SCT=subcutaneous tissue thickness; *OINL=optimal intramuscular needle length (SCT+0.6 cm); RRIL=rate of reaching intramuscular layer; †OINL/SFT.

Table 3
Regression of Skinfold Thickness with Subcutaneous Tissue Thickness
jkan-40-844-i003

DSCT=Dorsogluteal subcutaneous tissue thickness, VSCT=Ventrogluteal subcutaneous tissue thickness, DSFT=Dorsogluteal skinfold thickness, VSFT=Ventrogluteal skinfold thickness; x=Skinfold Thickness, y=Subcutaneous Tissue Thickness.

Notes

This work was supported by the Korean Research Foundation Grant Funded by the Korean Government (KRF-2008-314-E00270).

References

1. Bae NK, Kwon IS, Cho YC. Changes in obesity for 10 years (1997-2007) and its related factors in Korean adults. Korean Journal of Obesity. 2009. 18:24–30.
2. Burbridge BE. Computed tomographic measurement of gluteal subcutaneous fat thickness in reference to failure of gluteal intramuscular injection. Canadian Association of Radiologists Journal. 2007. 58:72–75.
3. Chan VO, Colville L, Persaud T, Buckley O, Hamilton S, Torreggiani WC. Intramuscular injections into the buttocks: Are they truly intramuscular? European Journal of Radiology. 2006. 58:480–484.
4. Cook IF, Williamson M, Pond D. Definition of needle length required for intramuscular deltoid injection in elderly adults: An ultrasonographic study. Vaccine. 2005. 24:937–940.
5. Durnin JV, Womersley J. Body fat assessed from total body density and its estimation from skinfold thickness: Measurements on 481 men and woman aged from 16 to 72 years. The British Journal of Nutrition. 1974. 32:77–97.
6. Faul F, Erdfelder E, Lang AG, Buchner A. G*power 3: A flexible statistical power analysis program for the social, behavioral, and biomedical sciences. Behavior Research Methods. 2007. 39:175–191.
7. Garcia AL, Wagner K, Hothorn T, Koebnick C, Zunft HJ, Trippo U. Improved prediction of body fat by measuring skinfold thickness, circumferences, and bone breadths. Obesity Research. 2005. 13:626–634.
8. Haramati N, Lorans R, Lutwin M, Kaleya R. Injection granulomas. Intramuscle or intrafat? Archives of Family Medicine. 1994. 3:146–148.
9. Huffman GB. Optimal needle length for immunizations in adults. American Family Physician. 1997. 56:2337.
10. Joo G, Sohng KY. Gluteal subcutaneous fat thickness measured by computed tomography as an estimate of proper gluteal intramuscular injections in Korean adults. Journal of Korean Academy of Nursing. 2010. 40:247–254.
11. Kim MJ, Park HS, Choi SH, Sohng KY, Kim HS, Nam JJ, et al. Recent Fundamentals of Nursing. 2005. Seoul: Hyunmoonsa.
12. Korean Society for the Study of Obesity. The Asia-Pacific perspective: Redefining obesity and its treatment. 2000. Seoul: Han medical publishing.
13. Lippert WC, Wall EJ. Optimal intramuscular needle-penetration depth. Pediatrics. 2008. 122:e556–e563.
14. Morely M, Babiar H. Obesity prevents injections from reaching muscle. American Physicians. 2005. Retrieved November 28, 2005. from http://www.rsna.org/rsna/media/pr2005/obesty.cfm.
15. Newton M, Newton DW, Fudin J. Reviewing the big three injection routes. Nursing. 1992. 22:34–42.
16. Nicoll LH, Hesby A. Intramuscular injection: An integrative research review and guideline for evidence-based practice. Applied Nursing Research. 2002. 15:149–162.
17. Nisbet AC. Intramuscular gluteal injections in the increasingly obese population: Retrospective study. British Medical Journal (Clinical research ed.). 2006. 332:637–638.
18. Nooyens AC, Koppes LL, Visscher TL, Twisk JW, Kemper HC, Schuit A, et al. Adolescent skinfold thickness is a better predictor of high body fatness in adults than body mass index: The Amsterdam growth and health longitudinal study. The American Journal of Clinical Nutrition. 2007. 85:1533–1539.
19. Poland GA, Borrud A, Jacobson RM, McDermott K, Wollan PC, Brakke D, et al. Determination of deltoid fat pad thickness. Implications for needle length in adult immunization. The Journal of the American Medical Association. 1997. 277:1709–1711.
20. Potter PP, Perry AG. Fundamentals of Nursing. 2007. New York: Elservier Inc.
21. Rai S, Nandan N. Gluteal injections in increasingly obese population: Essential considerations for intramuscular injections. British Medical Journal (Clinical research ed.). 2006. 332:795.
22. Sohng KY. Evaluation of nutritional deficit status in hemodialysis patients based on usual dietary intake, anthropometric and biochemical parameters. Journal of Korean Academy of Fundamentals Nursing. 1996. 3:68–80.
23. Sohng KY, Kim AY, Lee YO, Kim JS, Song HS, Kim SE, et al. Fundamentals of Nursing. 2008. Seoul: Soomoonsa.
24. Wolfson M, Christy JS, Minturn K, Gray DK, Kopple JK. Nutritional status and lymphocyte function in maintenance hemolysis patients. The American Journal of Clinical Nutrition. 1984. 37:547–555.
25. Zaybak A, Gunes UY, Tamsel S, Khorshid L, Eser I. Dose obesity prevent the needle from reaching muscle in intramuscular injections? Journal of Advanced Nursing. 2007. 58:552–556.
26. Zuckerman J. Importance of needle size for effective intramuscular delivery of vaccines. The British Journal of General Practice. 2000. 50:753.
TOOLS
Similar articles