Intradermal injection, often abbreviated ID, is a shallow or superficial

injection Injection or injected may refer to: Science and technology * Injective function, a mathematical function mapping distinct arguments to distinct values * Injection (medicine), insertion of liquid into the body with a syringe * Injection, in broadca ...

of a substance into the

dermis The dermis or corium is a layer of skin between the epidermis (with which it makes up the cutis) and subcutaneous tissues, that primarily consists of dense irregular connective tissue and cushions the body from stress and strain. It is divided i ...

, which is located between the

epidermis The epidermis is the outermost of the three layers that comprise the skin, the inner layers being the dermis and hypodermis. The epidermis layer provides a barrier to infection from environmental pathogens and regulates the amount of water rele ...

and the

hypodermis The subcutaneous tissue (), also called the hypodermis, hypoderm (), subcutis, superficial fascia, is the lowermost layer of the integumentary system in vertebrates. The types of cells found in the layer are fibroblasts, adipose cells, and macro ...

. For certain substances,

administration Administration may refer to: Management of organizations * Management, the act of directing people towards accomplishing a goal ** Administrative assistant, Administrative Assistant, traditionally known as a Secretary, or also known as an admini ...

via an ID route can result in a faster systemic uptake compared with

subcutaneous injection Subcutaneous administration is the insertion of medications beneath the skin either by injection or infusion. A subcutaneous injection is administered as a bolus into the subcutis, the layer of skin directly below the dermis and epidermis, ...

s, leading to a stronger immune response to vaccinations, immunology and novel cancer treatments, and faster drug uptake. Additionally, since administration is closer to the surface of the skin, the body's reaction to substances is more easily visible. However, due to complexity of the procedure compared to subcutaneous injection and

intramuscular injection Intramuscular injection, often abbreviated IM, is the injection of a substance into a muscle. In medicine, it is one of several methods for parenteral administration of medications. Intramuscular injection may be preferred because muscles have ...

, administration via ID is relatively rare, and is only used for

tuberculosis Tuberculosis (TB) is an infectious disease usually caused by '' Mycobacterium tuberculosis'' (MTB) bacteria. Tuberculosis generally affects the lungs, but it can also affect other parts of the body. Most infections show no symptoms, in ...

and

allergy Allergies, also known as allergic diseases, refer a number of conditions caused by the hypersensitivity of the immune system to typically harmless substances in the environment. These diseases include hay fever, food allergies, atopic derma ...

tests, Monkeypox vaccination, and certain therapies.

Injection sites

Common injection sites include the inner surface of the

forearm The forearm is the region of the upper limb between the elbow and the wrist. The term forearm is used in anatomy to distinguish it from the arm, a word which is most often used to describe the entire appendage of the upper limb, but which in anat ...

and the upper back, under the

shoulder blade The scapula (plural scapulae or scapulas), also known as the shoulder blade, is the bone that connects the humerus (upper arm bone) with the clavicle (collar bone). Like their connected bones, the scapulae are paired, with each scapula on either ...

Equipment

Equipment include

syringe A syringe is a simple reciprocating pump consisting of a plunger (though in modern syringes, it is actually a piston) that fits tightly within a cylindrical tube called a barrel. The plunger can be linearly pulled and pushed along the inside ...

s calibrated in tenths and hundredths of a

milliliter The litre (international spelling) or liter (American English spelling) (SI symbols L and l, other symbol used: ℓ) is a metric unit of volume. It is equal to 1 cubic decimetre (dm3), 1000 cubic centimetres (cm3) or 0.001 cubic metre (m3). ...

. The dosage given is usually less than 0.5 mL, less than given subcutaneously or intramuscularly. A and 26 or 27

gauge Gauge ( or ) may refer to: Measurement * Gauge (instrument), any of a variety of measuring instruments * Gauge (firearms) * Wire gauge, a measure of the size of a wire ** American wire gauge, a common measure of nonferrous wire diameter, es ...

thick needle is used.

Mantoux procedure

The traditional procedure of ID injection known as the Mantoux procedure (as used in the

Mantoux test The Mantoux test or Mendel–Mantoux test (also known as the Mantoux screening test, tuberculin sensitivity test, Pirquet test, or PPD test for purified protein derivative) is a tool for screening for tuberculosis (TB) and for tuberculosis diagn ...

) involves injecting at angle of administration of 5 to 15 degrees angle, almost against the skin. With

bevel A bevelled edge (UK) or beveled edge (US) is an edge of a structure that is not perpendicular to the faces of the piece. The words bevel and chamfer overlap in usage; in general usage they are often interchanged, while in technical usage they ...

(opening) side up, the needle is inserted about with the entire bevel inside and injected while watching for a small wheal or

blister A blister is a small pocket of body fluid (lymph, serum, plasma, blood, or pus) within the upper layers of the skin, usually caused by forceful rubbing (friction), burning, freezing, chemical exposure or infection. Most blisters are filled wi ...

to appear.

Intradermic needles

Traditionally

hypodermic needle A hypodermic needle (from Greek ὑπο- (''hypo-'' = under), and δέρμα (''derma'' = skin)), one of a category of medical tools which enter the skin, called sharps, is a very thin, hollow tube with one sharp tip. It is commonly used w ...

s are used for intradermal injections, instead of intradermic needles. Various microneedle technology researchers worldwide develop new devices and therapies to overcome typical usability issues associated with the traditional Mantoux procedure. Most intradermic needles require a change in injection technique or instruction to use, for example a perpendicular intradermal injection. Immune reaction tests sometimes use a set of non-hollow needles for scarification, shallowly abrading the skin. The inoculation is limited to the dermis.

References

{{Authority control Medical procedures Injection (medicine)

Injection sites

Equipment

Mantoux procedure

Intradermic needles

See also

References