The Effect of Two Types of Subcutaneous Heparin Injections on Pain, Ecchymosis, Hematoma and Drug Absorption: A Quasi-Experimental Study

• Published in: Journal of evaluation in clinical practice 2025-02, Vol.31 (1), p.e14266
• Main Authors: Bayram, Sule Biyik, Gulnar, Emel, Calıskan, Nurcan, Kosucu, Polat, Bektas, Onur, Bayram, Aysun, Aksoy, Fatma
• Format: Article
• Language: English
• Subjects: Adult; Aged; Anticoagulants - administration & dosage; Anticoagulants - adverse effects; Anticoagulants - pharmacokinetics; Ecchymosis; Female; Hematoma; Heparin - administration & dosage; Heparin - adverse effects; Humans; Injections, Subcutaneous - methods; Male; Middle Aged; Pain - drug therapy; Turkey; Ultrasonography - methods
• ISSN: 1365-2753; 1365-2753
• DOI: 10.1111/jep.14266

Subcutaneous heparin injections sometimes cause pain, ecchymosis, and hematoma. The prevalence of complications depends on the injection site, technique, and drug absorption. This study investigated the effect of two types of subcutaneous heparin injections on pain, ecchymosis, and hematoma as well as drug absorption rates. The study is a quasi-experimental. The research was conducted between September 2021 and May 2022. The sample consisted of 122 patients treated in the general surgery clinic of a university hospital in the Black Sea region of Türkiye. We used ultrasonography (USG) to measure the subcutaneous tissue thicknesses of the sites before heparin injections. We used the tissue-releasing technique (TRT) to administer heparin injections to 68 participants (Group TRT). We used the tissue-pinching technique (TPT) to administer heparin injections to 54 participants (Group TPT). We administered all injections into the arm or abdomen. We used a "Subcutaneous Injection Form" to collect data. We monitored all participants for the injection site, drug absorption after 1 day, pain, ecchymosis, and hematoma for 3 days. There was no significant difference in the prevalence of pain, ecchymosis, and hematoma between the groups (p > 0.05). Most injections into the arm and abdomen resulted in drug absorption. However, one in ten injections into the arm resulted in the needle reaching the muscle rather than the subcutaneous tissue (11.7%). Abdominal injections caused no complications. The drug was administered in the right place in abdominal injections. The tissue-releasing and TPTs are not superior to each other as far as drug absorption, pain, ecchymosis, and hematoma are concerned. In this study recommend pinching the tissue or using the abdominal region in cases where the subcutaneous tissue thickness is less than 15.96 mm. The nurse should consider Body Mass Index before choosing the right subcutaneous heparin injection site and the correct injection technique.