Sutureless Securement Device Reduces Complications of Peripherally Inserted Central Venous Catheters

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PURPOSE

This study was conducted to evaluate the performance of a sutureless adhesive-backed device, StatLock, for securement of peripherally inserted central venous catheters (PICCs). Earlier studies have demonstrated that StatLock significantly reduces catheter-related complications when compared to tape. The purpose of this study was to determine whether a sutureless securement device offers an advantage over suture in preventing catheter-related complications.

MATERIALS AND METHODS

170 patients requiring PICCs, which were randomized to suture (n = 85) or StatLock (n = 85) securement were prospectively studied. Patients were followed throughout their entire catheter course, and PICC-related complications including dislodgment, infection, occlusion, leakage, and central venous thrombosis were documented. Catheter outcome data were compared to determine if statistically significant differences existed between the suture and StatLock groups.

RESULTS

The groups had equivalent demographic characteristics and catheter indications. Average securement time with StatLock was significantly shorter (4.7 minutes vs 2.7 minutes; P < .001). Although StatLock was associated with fewer total complications (42 vs 61), this difference did not achieve significance. However, there were significantly fewer PICC-related bloodstream infections in the StatLock group (2 vs 10; P = .032). One securement-related needle-stick injury was documented during suturing of a PICC.

CONCLUSION

The sutureless anchor pad was beneficial for both patients and health care providers. Further investigation to determine how StatLock helps reduce catheter-related blood stream infections is necessary.

Section snippets

Study Design

Approval to conduct this prospective, randomized trial was granted by the institutional review board. Each study subject gave verbal informed consent before enrollment. The randomization was performed with concealed envelopes that designated patients to receive the standard securement with interrupted 2–0 Prolene (Ethicon, Somerville, NJ) or StatLock.

Catheter Insertion

An educational program reviewed the current suture method and introduced StatLock to staff members of the interventional radiology section. Single

Insertion Data

Twenty-five different operators used the suture technique and 28 operators used the StatLock. Average securement time was 4.7 minutes in the suture group and 2.7 minutes in the sutureless group (P < .001). The average securement ease/satisfaction scores were 7.2/7.3 for suture and 7.0/7.1 for StatLock (P = NS in both cases), respectively. Two patients could not be enrolled into the study. Excessive bleeding prevented adhesion of the StatLock in the first patient and the PICC catheter wing

DISCUSSION

A prospective, randomized study was conducted in two well-balanced patient groups comparing suture technique to a sutureless anchor pad for PICC securement. The anchor pad significantly reduced the length of time required to secure catheter to skin. Operators who used StatLock expressed equivalent ease and satisfaction with the device compared to suture technique. Follow-up demonstrated that StatLock secured catheters as well or better than suture, it significantly reduced line infections, and

CONCLUSION

The availability of StatLock as an alternative to tape and suture for securement of PICCs poses several clinical implications. It significantly reduces line infections. StatLock performs as well or better than suture in preventing catheter-related complications, particularly dislodgment and migration. In addition, it avoids the additional hazards associated with operator needle-stick injury and complies with recent federal guidelines. Future investigation must focus on how StatLock reduces

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From the 2001 SCVIR Annual Meeting.

This study was supported by an educational grant from Venetec International, San Diego, CA.

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