Needle Fragments an Invisible Enemy for People with Diabetes

In a letter to the June 21 issue of Journal of American Medicine, several physicians at the Medical University of South Carolina detailed their observations of six patients with diabetes who were suffering from needle fragments buried in the skin.

Although “silent needle” penetration has gone largely ignored, the letter’s authors report that six patients they saw who had tiny needle pieces buried in their tissue suffered from a variety of recurrent ailments, some of them severe. Two of the subjects had severe muscle weakness, three had neuropathic joint problems in the foot and ankle and one had amputation of the right great toe due to osteomyelitis.

The feet were especially prone to injury, as fragments can easily bury themselves in carpeted floors. One patient, however, had a fragment in the shoulder, and another had a fragment in the abdominal wall. All six patients suffered from neuropathy, and were unaware of the presence of needle shards.

The physicians write that needle disposal may be at the heart of the problem. One of the letter’s authors, Dr. Satish Nadig, AB, has noted separately that the practice of breaking old needles off of syringes to prevent misuse may do more harm than good. Nadig says this practice can cause small needle fragments to fall onto the floor, where they can be stepped on, or even send shards flying into the skin. The presence of fragments in subjects’ abdomens and shoulders, however, indicates that other forms of incorrect needle use may be at fault as well.

The physicians write that simple precautions can greatly reduce the chances of needle fragment injury. They caution against going barefoot, especially on carpeted floors, and to exercise more caution when disposing of their needles. The letter also urges doctors to screen their patients for puncture wounds and to scan radiographs carefully for metal fragments.

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