Purpose: To evaluate the infection rate after botulinum toxin type A injection without the use of isopropyl alcohol antisepsis. Isopropyl alcohol 70% solution has been used for routine skin preparation prior to botulinum toxin injection for decades; however, alcohol antisepsis does not routinely sterilize the skin, and it may not reduce the injection site infection rate.
Methods: The authors performed a retrospective analysis of patients undergoing botulinum toxin type A injection without the use of isopropyl alcohol antisepsis from one surgeon from October 1999 through December 2004. Charts were reviewed for patient age, gender, indication, total number of visits, total number of needles, total number of injections, and complications attributable to infection.
Results: One hundred forty-two patients underwent botulinum toxin type A injection without isopropyl alcohol antisepsis during the study period. Patients underwent a total of 11,627 injections during the study period. Average number of visits was 6 (range, 1-25 visits). Average follow-up was 707 days (range, 7-2,165 days). No patient receiving botulinum toxin type A injection without isopropyl alcohol antisepsis sustained a local complication consistent with infection.
Conclusions: Injection of botulinum toxin type A reconstituted with preserved saline results in an extremely low rate of infection.