Gluteal Subcutaneous Fat Thickness Measured by Computed Tomography as an Estimate of Proper Gluteal Intramuscular Injections in Korean Adults

Joo, Gaeul; Sohng, Kyeong-Yae

doi:10.4040/jkan.2010.40.2.247

J Korean Acad Nurs. 2010 Apr;40(2):247-254. Korean.
Published online Apr 30, 2010.
https://doi.org/10.4040/jkan.2010.40.2.247

Original Article

Gluteal Subcutaneous Fat Thickness Measured by Computed Tomography as an Estimate of Proper Gluteal Intramuscular Injections in Korean Adults

Gaeul Joo,¹ and Kyeong-Yae Sohng²

Author information

Author notes

Copyright and License

- ¹Research Assistant, College of Nursing, The Catholic University of Korea, Seoul, Korea.
- ²Professor, College of Nursing, The Catholic University of Korea, Seoul, Korea.
Address reprint requests to: Sohng, Kyeong-Yae. College of Nursing, The Catholic University of Korea, 505 Banpo-dong, Seocho-gu, Seoul 137-701, Korea. Tel: 82-2-2258-7410, Fax: 82-2-2258-7772, Email: sky@catholic.ac.kr

Received September 17, 2009; Revised September 18, 2009; Accepted March 30, 2010.

Abstract

Purpose

To study the thickness of gluteal subcutaneous fat (SCF) and propose an adequate length for needle for gluteal intramuscular injections based on computed tomography (CT) measurements.

Methods

The thickness of gluteal SCF were measured and studied for 568 patients who visited a tertiary hospital in Seoul, Korea between January 2007 and February 2009 for routine health screening and who had abdominopelvic CT.

Results

The average thickness of gluteal SCF was 15.92±4.08 mm in males and 24.90±5.47 mm in females. The thickness of gluteal SCF differed significantly according to gender. The gluteal SCF thickness was greater than 20.4 mm for 54 (12.3%) of the 440 male patients and 99 (77.3%) of the 128 female patients.

Conclusion

The most common syringe needle used for gluteal intramuscular injections in Korea is a 23 G, 25.4 mm-needle. The SCF thickness must be less than 20.4 mm in order to reach the dorsogluteal muscles to a depth of at least 5 mm if this 25.4 mm needle is used. In many patients, especially in female patients, the 25.4 mm needles will result in improper intramuscular injections with the injection being into the SCF. Therefore an appropriate needle should be selected by considering the gender and SCF thickness of patients receiving gluteal intramuscular injections.

Keywords

Injections; Intramuscular; Needles; Subcutaneous fat

Figures

Figure 1
CT image demonstrating the location of landmarks for gluteal fat measurement.

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Tables

Table 1
General Characteristics of the Participants (N=568)

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Table 2
Differences in Subcutaneous Fat Thickness between Gender (N=568)

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Table 3
Correlation of Age and BMI with Subcutaneous Fat Thickness (N=568)

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Table 4
Regression of BMI with Subcutaneous Fat Thickness (N=568)

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Table 5
Difference of Subcutaneous Thickness between BMI Groups (N=568)

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Notes

This article is a revision of the first author's master's thesis from the Catholic University of Korea.

References

1. Beyea SC, Nicoll LH. Administration of medications via the intramuscular route: An integrative review of the literature and research-based protocol for the procedure. Applied Nursing Research 1995;8:23–33.
1. Burbridge BE. Computed tomographic measurement of gluteal subcutaneous fat thickness in reference to failure of gluteal intramuscular injections. Canadian Association of Radiologists Journal 2007;58(2):72–75.
1. Chan VO, Colville J, Persaud T, Buckley O, Hamilton S, Torreggiani WC. Intramuscular injections into the buttocks: are they truly intramuscular? European Journal of Radiology 2006;58:480–484.
1. Cockshott WP, Thompson GT, Howlett LJ, Seeley ET. Intramuscular or intralipomatous injections? The New England Journal of Medicine 1982;307:356–358.
1. Haramati N, Lorans R, Lutwin M, Kaleya RN. Injection granulomas. Intramuscle or intrafat? Archives of Family Medicine 1994;3:146–148.
1. Hesby A, Nicoll LH. Intramuscular injection: An integrative research review and guideline for evidence-based practice. Applied Nursing Research 2002;15:149–162.
1. Kim CS. A study on the practice of intramuscular injection of staff nurses working in a hospital. Journal of Human Science 1984;8:87–93.
1. Kim MJ, Park HS, Choi SH, Sohng KY, Kim HS, Nam JJ, et al. In: Fundamentals of nursing. 2nd ed. Seoul: Hyunmoonsa; 2005.
1. Kim SJ, Lee SO, Kim MJ, Park JH, Jin EH, Son JT, et al. In: Fundamentals of nursing. 7th ed. Seoul: Soomoonsa; 2005.
1. Korea Centers for Disease Control and Prevention. Third national health survey results and in-depth analysis: health check up. Seoul: Author; 2007 Apr.
1. Korean Society for the Study of Obesity. The Asia-Pacific perspective: Redefining obesity and its treatment. Seoul: Author; 2006 Feb.
  (Original work published 2000).
1. Lenz CL. Make your needle selection right to the point. Nursing 1983;13(2):50–51.
1. Lippert WC, Wall EJ. Optimal intramuscular needle-penetration depth. Pediatrics 2008;122:556–563.
1. Mallett J, Dougherty L. In: Royal Marsden Hospital manual of clinical nursing procedures. 5th ed. Oxford: Blackwell Science; 2000.
1. Analysis of 2007 Health Check Up Results. National Health Insurance Corporation data. 2009 Jan 06 [Retrieved May 25, 2009].
  from http://www.nhic.or.kr/wbm/wbmc/wbmc_0400/wbmc_0405/wbmc_0405.html.
1. Newton M, Newton DW, Fudin J. Reviewing the big three injection routes. Nursing 1992;22(2):34–41.
1. Nisbet AC. Intramuscular gluteal injections in the increasingly obese population: retrospective study. British Medical Journal 2006;332:637–638.
1. Poland GA, Borrud A, Jacobson RM, McDermott K, Wollan PC, Brakke D, et al. Determination of deltoid fat pad thickness. Implications for needle length in adult immunization. The Journal of the American Medical Association 1997;277:1709–1711.
1. Rai S, Nandan N. Gluteal injections in increasingly obese population: Essential considerations for intramuscular injections. British Medical Journal 2006;332:795.
1. Sohng KY, Park HS, Hong YH, Yun EJ, Lee KY, Cho BH, et al. In: Fundamentals of nursing II. Seoul: SooMoonsa; 2008.
1. Sohng KY, Park HS, Hong YH, Yun EJ, Lee KY, Cho BH, et al. In: Fundamentals of nursing Interventions and skills. Seoul: SooMoonsa; 2009.
1. Son JT, Jang EH, Ha NS, Lee HJ, Yang JH, Kim HM, et al. In: Fundamentals of nursing II. Seoul: Hyunmoonsa; 2007.
1. Zaybak A, Gunes UY, Tamsel S, Khorshid L, Eser I. Does obesity prevent the needle from reaching muscle in intramuscular injections? Journal of Advanced Nursing 2007;58:552–556.