Before Insertion: cleansing pump & sensor sites
When it comes to applying insulin pump infusion sets and CGM/Libre sensors, best practice involves making sure the insertion site is clean and dry to reduce the risk of skin irritation and infection. Here are some of those best practice methods, plus practical tips to clinch your success.
Depending on your child’s reaction to set changes, you may find it helpful to first numb the site before cleansing.
As with all procedures where hygiene and avoiding infection is critical, it’s important to make sure hands are clean before starting the set change: if your child/teen is doing his own set change, he should wash his hands; if you are physically assisting with the set change, or doing the set change yourself, you should wash your hands, too. Even with clean hands, it’s wise to avoid touching the end of the infusion set, the reservoir/cartridge needle, the open top of the reservoir/cartridge, and the top of the insulin bottle.
The planned infusion site also needs to be cleaned (an area about 7 or 8 cm in diameter). Cleansing with an alcohol swab is one often-recommended option. It may also work to use a small amount of regular soap, antibacterial soap, or antibacterial foam (such as Purell™) instead. Some pump users plan set changes to follow baths or showers, for added hygiene. Check with your child’s diabetes health care provider for individualized recommendations about site cleansing.
Tips from the Trenches
When we used alcohol swabs, we found that our son would get excessively dry skin, making it hard to find spots with healthy skin for new infusion sites. Since his endocrinologist suggested using only soap and water to clean the area before set changes, he has not had a problem with dryness. (We also haven’t had a problem with infections.) We put a small dab of soap on a damp paper towel, rub it onto his skin, then use another damp paper towel to wipe/rinse it off. This works well for us. ~Michelle
Our family has always used alcohol swabs for infusion site cleansing, and we have never had a problem, so that’s what we use. ~Danielle
The type of cleansers that your child uses before a set change, or simply as part of his regular bathing habits, could affect how well the infusion set stays on the skin. It may be wise to avoid using an ultra-moisturizing soap, or a soap designed for dry skin, on the body parts which you plan to use for infusion sites. These products may make the skin too “slippery” for an infusion set to adhere for the 2-3 days that you want it to stay on. For example, the following are great for dry skin, but not great for keeping infusion sets on:
- Dove™ Moisturizing Bar
- Cetaphil™ cream cleanser
- Moisturizing bubble bath
It’s important to let the skin dry thoroughly and naturally after cleansing, as moisture trapped against the skin (under an adhesive product such as infusion sets and sensors) can lead to skin irritation.
The above information was reviewed for content accuracy by clinical staff of the Alberta Children’s Hospital Diabetes Clinic.
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