Effect of sutureless securement on hemodialysis catheter-related bloodstream infection

Abstract

The use of sutureless securement devices during catheterization might reduce the risk of catheter-related bloodstream infection (CRBSI) by suppressing catheter-exit infection and catheter dislodgement. However, the effectiveness of these devices in reducing CRBSI risk when securing hemodialysis catheters has not been explored. This single-center retrospective observational study examined 211 non-tunneled hemodialysis catheters (NTHCs) from 110 hemodialysis inpatients, of which 121 were secured using conventional skin sutures (Suture group) and 90 with GRIP-LOK (GRIP-LOK group). The stabilized inverse probability of treatment (SIPT)-weighting method was used to generate a new population (SIPT-weighted model) without group differences for each of the 12 predictors of CRBSI development (i.e., age, sex, dialysis history, concomitant acute kidney injury or diabetes, concurrent use of immunosuppressant drugs or aspirin, NTHC insertion site, methicillin-resistant Staphylococcus aureus, carriage, bacteremia event within 3 months before catheterization, hemoglobin level, and serum albumin titer). The effect of GRIP-LOK compared with sutures on CRBSI in the SIPT-weighted model was evaluated using univariate SIPT-weighted Cox proportional regression analysis, which showed a significant CRBSI suppression effect of GRIP-LOK compared with sutures (hazard ratio: 0.17 [95% CI 0.04–0.78], p = 0.023). GRIP-LOK affords a lower risk of CRBSI due to indwelling NTHCs than conventional securement using sutures.

A Primer and Literature Review on Internal and External Retention Mechanisms for Catheter Fixation

“…Fujimoto et al conducted a retrospective cohort study in 2021 that compared the performance difference between traditional skin sutures and GRIP-LOK devices, a sutureless securement device. They found that the GRIP-LOK device was more effective than traditional skin sutures at preventing catheter-related bloodstream infections, catheter site exit infections, and catheter dislodgment in patients using a non-tunneled hemodialysis catheter [ 29 ]. Due to the better performance and decreased risk that is seen with the use of sutureless adhesive devices, the use of sutures for catheter securement has decreased [ 12 ].…”