A clinical evaluation of two central venous catheter stabilization systems

Abstract

Background Central venous catheters (CVCs) are commonly secured with sutures which are associated with microbial colonization and infection. We report a comparison of a suture-free system with standard sutures for securing short-term CVC in an international multicentre, prospective, randomized, non-blinded, observational feasibility study. Consented critical care patients who had a CVC inserted as part of their clinical management were randomized to receive either sutures or the suture-free system to secure their CVC. The main outcome measures were CVC migration (daily measurement of catheter movement) and unplanned catheter removals. Results The per cent of unplanned CVC removal in the two study groups was 2% (suture group 2 out of 86 patients) and 6% (suture-free group 5 out of 85 patients). Both securement methods were well tolerated in terms of skin irritation. The time and ease of application and removal of either securement systems were not rated significantly different. There was also no significant difference in CVC migration between the two securement systems in exploratory univariate and multivariate analyses. Overall, 42% (36 out of 86) of the CVC secured with sutures and 56% (48 out of 85) of the CVC secured with the suture-free securement system had CVC migration of ≥ 2 mm. Conclusions The two securement systems performed similarly in terms of CVC migration and unplanned removal of CVC; however, the feasibility study was not powered to detect statistically significant differences in these two parameters. Trial registration ISRCTN, ISRCTN13939744. Registered 9 July 2015, http://www.isrctn.com/ISRCTN13939744 .

Effectiveness of different central venous catheter fixation suture techniques: An in vitro crossover study

“…The Sorbaview ™ adhesive, in contrast, resulted in a lower dislodgement force (17 N). Another study found a trend towards an increased rate of accidental CVC pullout when the Statlock ™ adhesive approach was used compared to sutures [12] while recent data did not find statistical differences in unplanned CVC removal and CVC migration when using suture-free systems compared to sutures [11]. In two clinical studies comparing CVC sutures with a securing clamp, the authors found less time spent in clamp fixation than in suturing [18,19]; one of these studies observed superior strength than in sutures [19], whereas the other had unacceptable rates of accidental CVC pullout [18].…”

“…The effectiveness of different CVC fixation sutures is unknown [6]. Moreover, sutureless CVC fixation devices have recently become increasingly popular because of their less invasive nature and potentially greater patient comfort [7–11]. However, CVC fixation with sutures is still widely used and mandatory in high-risk patients (i.e., burns).…”

Update on prevention of intra-vascular accesses complications

“…Sutures disrupt the skin at the insertion site and may serve as a nidus for microbial growth. Sutureless devices are safe in ICU in term of CVL migrations and unplanned removal [16]. Hub contamination is common if scrubbing of the catheter hub is not properly done.…”

Management and Prevention of Central Venous Catheter-Related Infections in the ICU

“…Application of sutures disrupts the skin at the insertion site and may serve as a nidus for microbial growth. An innovative approach using a suture-free system has been proposed by Karpanen et al 74 This securement system performed similarly in terms of CVC migration and unplanned removal of CVC; however, to date, its effect on CR-BSI reduction has not been demonstrated.…”