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


Autoři: Manuel Florian Struck aff001;  Lars Friedrich aff001;  Stefan Schleifenbaum aff002;  Holger Kirsten aff003;  Wolfram Schummer aff004;  Bernd E. Winkler aff005
Působiště autorů: Department of Anesthesiology and Intensive Care Medicine, University Hospital Leipzig, Leipzig, Germany aff001;  ZESBO-Zentrum zur Erforschung der Stütz- und Bewegungsorgane, Leipzig, Germany aff002;  Institute for Medical Informatics, Statistics, and Epidemiology (IMISE), University of Leipzig, Leipzig, Germany aff003;  Department of Anesthesiology and Intensive Care Medicine, University Hospital Jena, Jena, Germany aff004;  Department of Anesthesiology and Intensive Care Medicine, University Hospital Würzburg, Würzburg, Germany aff005
Vyšlo v časopise: PLoS ONE 14(9)
Kategorie: Research Article
doi: 10.1371/journal.pone.0222463

Souhrn

Purpose

Proper fixation of central venous catheters (CVCs) is an integral part of safety to avoid dislodgement and malfunction. However, the effectiveness of different CVC securement sutures is unknown.

Methods

Analysis of maximum dislodgement forces for CVCs from three different manufacturers using four different suture techniques in an in vitro tensile loading experiment: 1. “clamp only”, 2. “clamp and compression suture”, 3. “finger trap” and 4. “complete”, i.e., “clamp + compression suture + finger trap”. Twenty-five tests were performed for each of the three CVC models and four securement suture techniques (n = 300 test runs).

Results

The primary cause of catheter dislodgement was sliding through the clamp in techniques 1 and 2. In contrast, rupture of the suture was the predominant cause for dislodgement in techniques 2 and 3. Median (IQR 25–75%) dislodgement forces were 26.0 (16.6) N in technique 1, 26.5 (18.8) N in technique 2, 76.7 (18.7) N in technique 3, and 84.8 (11.8) N in technique 4. Post-hoc analysis demonstrated significant differences (P < .001) between all pairwise combinations of techniques except technique 1 vs. 2 (P = .98).

Conclusions

“Finger trap” fixation at the segmentation site considerably increases forces required for dislodgement compared to clamp-based approaches.

Klíčová slova:

Biology and life sciences – Bioengineering – Biotechnology – Medical devices and equipment – Catheters – Agriculture – Animal products – Leather – Engineering and technology – Medicine and health sciences – Surgical and invasive medical procedures – Catheterization – Physical sciences – Physics – Classical mechanics – Compression – Materials science – Materials – Adhesives – Mathematics – Statistics – Statistical data – Probability theory – Probability distribution – Normal distribution – Research and analysis methods – Mathematical and statistical techniques – Statistical methods – Analysis of variance


Zdroje

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PLOS One


2019 Číslo 9

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