Storing a GAX-Collagen Syringe Seems Safe

OB/GYN News, Dec 15, 1999 by Doug Brunk

SAN DIEGO -- Don't be so quick to throw away partially used syringes of glutaraldehyde cross-linked collagen.

It may be safe and cost-effective to reuse them on the same patient for subsequent injections, according to results of a study presented at the annual meeting of the American Urogynecologic Association.

Repeat injections of glutaraldehyde cross-linked (GAX) collagen on a given patient with stress incontinence due to intrinsic sphincteric deficiency tend to require less material.

In fact, some patients need as little as 0.5 mL on subsequent injections, noted Dr. Patrick Culligan, who conducted the research while at the Evanston (Ill.) Hospital.

Since GAX collagen is available only in 2.5 mL increments, subsequent injections can result in significant wastage, he said. Each 2.5 mL syringe costs about $315.

Dr. Culligan and his associates stored 56 partially used syringes for an average of 15 weeks. They obtained aerobic cultures by inoculating 1 to 2 mL of material from each syringe into broth culture and incubated them at 35 degrees Celsius for 5 days. A smaller sample (0.5 mL) from each syringe was inoculated onto a chocolate agar plate and incubated at 2230 degrees Celsius for 5 days.

Only one of the 56 syringes tested positive for coagulase negative staphylococcus. However, subsequent cultures of the material in this syringe were negative.

Dr. Culligan, who is now with the section of urogynecology at the University of Louisville (Ky.), speculated that the organism could have resulted from contamination either at the time of initial injection or during the culturing process.