The American Diabetes Association’s Position on Syringe Re-Use

Manufacturers of disposable syringes recommend that they be used only once because the sterility of a reused syringe cannot be guaranteed. However, some individuals prefer to reuse a syringe until its needle becomes dull. Most insulin preparations have bacteriostatic additives that inhibit growth of bacteria commonly found on the skin. For many patients, it appears both safe and practical for the syringe to be reused if the patient so desires. The syringe should be discarded when the needle becomes dull, has been bent, or has come into contact with any surface other than the skin; if reuse is planned, the needle must be recapped after each use.

Syringe reuse may carry an increased risk of infection for some individuals. Patients with poor personal hygiene, an acute concurrent illness, open wounds on the hands, or decreased resistance to infection for any reason should not reuse a syringe. Patients reusing a syringe should periodically inspect the skin around an injection site for unusual redness or signs of infection. Individuals should consult their physicians before initiating the practice of syringe reuse and whenever injection-site infection is suspected.

Before syringe reuse is considered, it should be determined that the patient is capable of safely recapping a syringe. Proper recapping requires adequate vision, manual dexterity, and no obvious tremor. The patient should be instructed in a recapping technique that supports the syringe in the hand and replaces the cap with a straight motion of the thumb and forefinger. The technique of guiding both the needle and cap to meet in midair should be discouraged, because this frequently results in needle-stick injury.

The syringe being reused may be stored at room temperature. The potential benefits or risks, if any, of refrigerating the syringe in use or of using alcohol to cleanse the needle of a syringe are unknown. Cleansing the needle with alcohol may not be desirable, because it may remove the silicon coating that makes for less painful skin puncture.

Excerpted with the permission of the American Diabetes Association from Diabetes Care, Vol. 23, Supplement 1, Clinical Practice Recommendations 2000.

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