2. Efficacy and safety of needle free jet injector assisted intralesional treatments in dermatology—a systematic review. 39 2. 2. INTRODUCTION Intradermal drug delivery has many advantages over other routes of administration, especially high bioavailability in the skin.1,2 Over the past decades, a variety of needlefree devices that enable intradermal drug delivery has been developed, including fractional ablative lasers, iontophoresis, sonophoresis, and various types of mechanical and energy-based jet injectors.3-5 Jet injectors are commonly used for the intralesional treatment of several dermatological conditions such as keloids, hypertrophic scars, and recalcitrant viral warts.6,7 Traditional mechanical jet injectors act with a fixed pressure predetermined by spring size.8 Innovative electronically controlled pneumatic jet injectors are devices in which volume and pressure can be controlled by accelerated and compressed gas as pressure source, which dispense fluids into the skin.7,9 Other types of jet injectors are controlled by Lorentz or piezoelectric actuators, lasers, and shockwaves to pressurize the injected drug.10 In contemporary healthcare, we are moving towards more patient-centered care. It is important to improve patient comfort and avoid physical or psychological harm as much as possible. According to a previous study, 63% of children and 24% of the adult population in the USA fear needles.11 This is one of the reasons why jet injectors can be a viable alternative for conventional needles.Needle-free jet injectors can be an attractive alternative for hypodermic needles for patients experiencing needle phobia, minimize treatment-related pain, and are free of risk for needlestick injuries and crosscontamination. Additionally, jet injectors enable accurate and reproducible dermal delivery of liquid drugs and disperse the drug more evenly in the skin than conventional needle injections.7, 9, 12, 13 At present, there are a few overviews and narrative reviews describing the use of jet injector-assisted intralesional treatment for different dermatological indications.7, 10, 12, 14 However, a systematic and critical review that evaluates the efficacy and safety of jet injector-assisted intralesional treatment in dermatology is lacking. In this review, we aimed to systematically review and evaluate the quality of clinical evidence for intralesional treatment of dermatological indications using needle-free jet injector systems and provide evidence-based recommendations for clinical practice.
RkJQdWJsaXNoZXIy MTk4NDMw