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A study on the reconstitution of botulinum toxin type A: normal saline versus bacteriostatic saline

02 February 2023
Volume 12 · Issue 1

Abstract

Background:

This is a quantitative study on the reconstitution of botulinum toxin type A, whether medical aesthetics nurses use normal saline or bacteriostatic saline to reconstitute and what wider factors influence this clinical decision. Medical aesthetics nurses have not previously participated in this area of research. The existing research uses doctors as participants and excludes nurses. Ultimately, the decision lies with the prescriber, but there is a notable gap in knowledge and a need to explore the preferred practice of medical aesthetics nurses.

Methods:

An anonymous online survey was conducted with participants who were medical aesthetics nurses, based in the UK and members of the British Association of Cosmetic Nurses. The survey tool was used to gather data on whether medical aesthetics nurses reconstitute botulinum toxin type A with preserved or normal saline.

Results:

93.2% of participants used bacteriostatic saline to reconstitute botulinum toxin type A. Some 88.6% of participants were nurse independent prescribers, while 45.4% of participants had a minimum of 10 years' experience in medical aesthetics. All participants were trained by either a nurse or doctor.

Conclusions:

Medical aesthetics nurses are highly educated and motivated independent nurses. They have enterprising skillsets and it is highly unusual to find nurses with established private practices outside the specialism of medical aesthetics. Botulinum toxin type A treatments are one of the core treatments in any patient-centred, independent practice and are very much results driven. Sustaining high levels of patient satisfaction is an essential part of medical aesthetics nursing.

The specialist area of medical aesthetics originates from aesthetic surgery, which is a branch of plastic surgery (Campion, 2012). There has been a rise in the number of registered nurses practising medical aesthetics (Di-Scala, 2017), and it is the largest area of growth within personal care and wellness (Advertising Standards Agency, 2018). However, statistics show that medical aesthetics treatments are still relatively new in comparison to cosmetic surgery procedures.

The British Association of Aesthetic Plastic Surgeons (BAAPS) (2014) reported that the number of patients undergoing cosmetic surgery had declined by 9%. In 2017, a further audit identified a decrease of 7.9% from 2016 figures for the number of men and women undergoing cosmetic surgical procedures (Cooke, 2018).

The International Society of Aesthetic Plastic Surgery (ISAPS) stated that, in 2019, botulinum toxin remained the most popular non-surgical treatment across the globe. There was an increase of 7.6% in non-surgical procedures compared to the previous year (ISAPS, 2020). In the USA, surgeons reported that 1 712 994 botulinum toxin treatments were performed in 2019 (The Aesthetic Society, 2019).

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