Table 4.

Factors to Consider When Choosing an Infusion Site.

Body composition and distribution of subcutaneous tissue: Look for places on the skin where you can “pinch an inch” to ensure there is adequate subcutaneous tissue (eg, for males, more around the abdomen; for females, more around hips and upper thighs). •Avoid skin folds because of difficulty securing the cannula, which could lead to impaired absorption[33] •Avoid areas where edema is present, as it may increase infection risk •Avoid bony areas, or areas near joints, where there is limited subcutaneous tissue and a higher potential for dislodgment •Avoid areas with dry skin or infected/broken skin, as it may increase the risk of infection

Ability to use alternative infusion site: It might be difficult for patients to apply the cannula to the flank or to the dominant arm by themselves.

Areas with excessive hair: To minimize issues with adhesiveness of cannula pad, avoid areas with excess hair, or consider removing hair without causing blade-related skin trauma. Trimming of hair is preferred. If shaving with a razor, consider doing so 1 or 2 days before cannula insertion. Alternatives to razor shaving are trimming or use of hair removal creams.

Sweating: To minimize issues with adhesiveness of cannula pad and risk of folliculitis (especially if blade-shaven), avoid areas where the patient sweats significantly, and avoid tight-fitting clothes on the chosen area. Also consider using commercially available ancillary adhesive materials.

Sleep position: Discuss expectations with patient to either adjust sleeping position or consider an alternative infusion site that does not impact sleep habits.

Physical activity and exercise: Consider choosing sites with the least risk of being impacted by physical activity, and consider using ancillary adhesive materials to prevent activity-related dislodgement of the cannula and subsequent inadequate infusion delivery (eg, intradermal rather than subcutaneous). Avoid sunscreen or lotion on the area, and if used, ensure the area is cleaned with alcohol pad/wipes and allowed to dry completely before inserting the cannula.

Patient preference: Patient’s desire for cannula concealment (thigh and flank) vs. no concealment (arm).