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Djordjevic I, Ellis E, Singh J, Ali N, Pena EM, Rajarethinam R, Manikandan L, Goh J, Lim S, Steele T. Color changing bioadhesive barrier for peripherally inserted central catheters. Biomater Sci 2024; 12:1502-1514. [PMID: 38284150 DOI: 10.1039/d3bm01347b] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/30/2024]
Abstract
Bacteria migration at catheter insertion sites presents a serious complication (bacteraemia) with high mortality rates. One strategy to mediate bacteraemia is a physical barrier at the skin-catheter interface. Herein a colorimetric biosensor adhesive (CathoGlu) is designed and evaluated for both colorimetric detection of bacterial infection and application as a bacteria barrier. The design intent combines viscous, hydrophobic bioadhesive with an organic pH indicator (bromothymol blue). Visual observation can then distinguish healthy skin at pH = ∼5 from an infected catheter insertion site at pH = ∼8. The liquid-to-biorubber transition of CathoGlu formulation occurs via a brief exposure to UVA penlight, providing an elastic barrier to the skin flora. Leachates from CathoGlu demonstrate no genotoxic and skin sensitization effect, assessed by OECD-recommended in vitro and in chemico assays. The CathoGlu formulation was found non-inferior against clinically approved 2-octyl-cyanoacrylate (Dermabond™), and adhesive tape (Micropore™) within an in vivo porcine model. CathoGlu skin adhesive provides new opportunities to prevent sepsis in challenging clinical situations.
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Affiliation(s)
- Ivan Djordjevic
- School of Materials Science and Engineering, Nanyang Technological University, 50 Nanyang Ave, Block N4.1, Singapore 639798.
| | - Elizabeth Ellis
- School of Materials Science and Engineering, Nanyang Technological University, 50 Nanyang Ave, Block N4.1, Singapore 639798.
| | - Juhi Singh
- NTU Institute for Health Technologies, Interdisciplinary Graduate Program, Nanyang Technological University, 61 Nanyang Drive, Singapore 637335
- School of Chemistry, Chemical Engineering and Biotechnology, 70 Nanyang Drive, Block N1.3, Nanyang Technological University, Singapore 637457
| | - Naziruddin Ali
- School of Materials Science and Engineering, Nanyang Technological University, 50 Nanyang Ave, Block N4.1, Singapore 639798.
| | - Edgar M Pena
- National Large Animal Research Facility, SingHealth Experimental Medicine Centre, Academia 20 College Road, Singapore 169856
| | - Ravisankar Rajarethinam
- Institute of Molecular and Cell Biology, Agency for Science, Technology and Research (A*STAR), 61 Biopolis Drive, Proteos, Singapore 138673
| | - Lakshmanan Manikandan
- Institute of Molecular and Cell Biology, Agency for Science, Technology and Research (A*STAR), 61 Biopolis Drive, Proteos, Singapore 138673
| | - Jason Goh
- Institute of Molecular and Cell Biology, Agency for Science, Technology and Research (A*STAR), 61 Biopolis Drive, Proteos, Singapore 138673
| | - Sierin Lim
- School of Chemistry, Chemical Engineering and Biotechnology, 70 Nanyang Drive, Block N1.3, Nanyang Technological University, Singapore 637457
| | - Terry Steele
- School of Materials Science and Engineering, Nanyang Technological University, 50 Nanyang Ave, Block N4.1, Singapore 639798.
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Hugill K, van Rens MFPT, Alderman A, Kaczmarek L, Lund C, Paradis A. Safe and effective removal of cyanoacrylate vascular access catheter securement adhesive in neonates. Front Pediatr 2023; 11:1237648. [PMID: 37691778 PMCID: PMC10492643 DOI: 10.3389/fped.2023.1237648] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/09/2023] [Accepted: 07/26/2023] [Indexed: 09/12/2023] Open
Abstract
Neonatal vascular access continues to pose challenges. Recent times have seen considerable innovations in practice and the design and manufacture of materials used to provide infusion-based therapies with the intent of reducing the incidence and severity of vascular access-related complications. However, despite these efforts, vascular access-related complication rates remain high in this patient group and research evidence remains incomplete. In neonates, a medical-grade formulation of cyanoacrylate adhesive is widely used to secure percutaneously inserted central venous catheters and is beginning to establish a role in supporting the effective securement of other devices, such as umbilical and peripheral intravenous catheters. This Perspective article considers issues specific to the removal of cyanoacrylate used to secure vascular access devices from neonatal skin before its bonding releases due to natural skin exfoliation processes. The aim of this information is to ensure the safe and effective removal of octyl-cyanoacrylate adhesive-secured vascular access catheters from neonatal skin and stimulate professional discussion.
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Affiliation(s)
- Kevin Hugill
- Nursing and Midwifery Education, Hamad Medical Corporation, Doha, Qatar
| | | | - Angela Alderman
- NICU, Carilion Children’s Hospital, Roanoke, VA, United State
| | | | - Carolyn Lund
- NICU, UCSF Benioff Children's Hospital, Oakland, CA, United State
- School of Nursing, University of California, San Francisco, CA, United State
| | - Amy Paradis
- NICU, CNS Doctors Medical Center, Modesto, CA, United State
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Padilla-Nula F, Bergua-Lorente A, Farrero-Mena J, Escolà-Nogués A, Llauradó-Mateu M, Serret-Nuevo C, Bellon F. Effectiveness of cyanoacrylate glue in the fixation of midline catheters and peripherally inserted central catheters in hospitalised adult patients: Randomised clinical trial (CIANO-ETI). SAGE Open Med 2023; 11:20503121231170743. [PMID: 37152837 PMCID: PMC10155010 DOI: 10.1177/20503121231170743] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2022] [Accepted: 04/03/2023] [Indexed: 05/09/2023] Open
Abstract
Objective The objective of the study was to assess the efficacy of the use of cyanoacrylate glue (CAG) as a means of securing midline catheters and peripherally inserted central catheters with the modified micro-Seldinger technique in adult hospitalised patients. Methods Randomised clinical trial with two groups (1:1): control and intervention. The control group received a securement method with a sutureless device plus transparent dressing and the intervention group received the same securement method plus the CAG. The study was approved by the Drug Research Ethics Committee of the Lleida Health Region. Results A total of 216 patients were assessed. The two groups of the trial were homogenously distributed in terms of sociodemographic and clinical variables. The intervention group had a statistically significant lower incidence of peri-catheter bleeding and/or oozing during the 7-day study period (odds ratio (OR), 0.6; 95% confidence level (CI), 0.44-0.81; p < 0.001) and a statistically significant lower incidence of catheter dislodgements during the first 24 h (OR, 0.2; 95% CI, 0.04-0.91; p = 0.03). There were no statistically significant differences in the incidence of phlebitis (OR, 1.30; 95% CI, 0.60-2.83; p = 0.56) or catheter-related pain (OR, 0.88; 95% CI, 0.40-1.94; p = 0.84). Conclusion Midline catheters and peripherally inserted central catheters secured with CAG had fewer complications than catheters not secured with this adhesive.
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Affiliation(s)
- Ferran Padilla-Nula
- Vascular Access Unit and Angioradiology
Unit of the University Hospital Arnau de Vilanova, Catalan Institute of Health,
Lleida, Spain
| | - Alejandro Bergua-Lorente
- Vascular Access Unit and Angioradiology
Unit of the University Hospital Arnau de Vilanova, Catalan Institute of Health,
Lleida, Spain
| | - Jordi Farrero-Mena
- Vascular Access Unit and Angioradiology
Unit of the University Hospital Arnau de Vilanova, Catalan Institute of Health,
Lleida, Spain
| | - Anna Escolà-Nogués
- Vascular Access Unit and Angioradiology
Unit of the University Hospital Arnau de Vilanova, Catalan Institute of Health,
Lleida, Spain
| | - Miriam Llauradó-Mateu
- Vascular Access Unit and Angioradiology
Unit of the University Hospital Arnau de Vilanova, Catalan Institute of Health,
Lleida, Spain
| | - Carme Serret-Nuevo
- Vascular Access Unit and Angioradiology
Unit of the University Hospital Arnau de Vilanova, Catalan Institute of Health,
Lleida, Spain
| | - Filip Bellon
- GESEC Group, Department of Nursing and
Physiotherapy, Faculty of Nursing and Physiotherapy, University of Lleida, Lleida,
Spain
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Zhang S, Price N, Guido A. Addition of cyanoacrylate adhesive improves the strength of catheter securement and integrity of transparent dressing: Results from an in vitro test model. J Vasc Access 2023:11297298231159177. [PMID: 36856232 DOI: 10.1177/11297298231159177] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/02/2023] Open
Abstract
INTRODUCTION Intravenous catheters present complications to patients, such as dislodgment, pistoning, micromovement, and infection. Despite the use of transparent dressings, a significant rate of I.V. catheter complications still arise. This article is to provide a scientific and technological perspective on how bonding a transparent dressing to a substrate using 2-octyl cyanoacrylate and n-butyl cyanoacrylate (OBCA) via multiple methods can significantly enhance the adhesion strength of the transparent dressing product, which subsequently increases the securement strength of the catheter. MATERIALS AND METHODS Using porcine skin, an adhesive formula made of a mixture of OBCA was applied to both the I.V. catheter and transparent dressing to evaluate the adhesion strength and securement strength in vitro. RESULTS The studies show that using OBCA to bond the transparent dressing to the substrate significantly improved the adhesion strength by up to 8 times, and catheter securement by up to 7.4 times stronger than using a transparent dressing alone. CONCLUSION It was determined that using OBCA to bond the transparent dressing to the substrate results in strengthening the adhesion strength of the transparent dressing, which could potentially reduce dressing complications. By using OBCA to affix the transparent dressing to the substrate catheter securement strength was also significantly increased which can potentially reduce catheter dislodgment, migration, and micromovement.
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van Rens MF, Spencer TR, Hugill K, Francia AL, van Loon FH, Bayoumi MA. Octyl-butyl-cyanoacrylate glue for securement of peripheral intravenous catheters: A retrospective, observational study in the neonatal population. J Vasc Access 2023:11297298231154629. [PMID: 36794683 DOI: 10.1177/11297298231154629] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/17/2023] Open
Abstract
BACKGROUND Evidence-based insertion and maintenance strategies for neonatal vascular access devices (VAD) exist to reduce the causes of VAD failure and complications in neonates. Peripheral intravenous catheter failure and complications including, infiltration, extravasation, phlebitis, dislodgement with/without removal, and infection are majorly influenced by catheter securement methods. METHODS A retrospective, observational study using routinely collected data on intravenous device use in a large neonatal intensive care unit in Qatar. A 6-month historical cohort was compared with a 6-month cohort after the introduction of an octyl-butyl-cyanoacrylate glue (CG). In the historical cohort, the catheter was secured using a semi-permeable transparent membrane dressing while in the CG cohort, CG was applied at the insertion site on initial insertion and after any dressing change. This was the only variable intervention between both groups. RESULTS A total of 8330 peripheral catheters were inserted. All catheters were inserted and monitored by members of the NeoVAT team. 4457 (53.5%) were secured with just a semi-permeable transparent dressing and 3873 (46.5%) secured a semi-permeable transparent dressing with the addition of CG. The odds ratio for premature failure after securement with CG was 0.59 (0.54-0.65) when compared to the catheters secured with a semi-permeable transparent dressing, which was statistically significant (p < 0.001). The correlation between the occurrence of a complication and the use of CG for device securement was significant (p < 0.001). CONCLUSIONS The risk of developing device-related phlebitis and premature device removal, increased significantly if CG was not used for adjunct catheter securement. In parallel with the currently published literature, this study's findings support the use of CG for vascular device securement. When device securement and stabilization concerns are most pertinent CG is a safe and effective adjunct to reducing therapy failures in the neonatal patient population.
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Affiliation(s)
| | | | - Kevin Hugill
- Department of Nursing and Midwifery Education, Hamad Medical Corporation, Doha, Qatar
| | - Airene Lv Francia
- Women's Wellness and Research Center, Hamad Medical Corporation, Doha, Qatar
| | - Fredericus Hj van Loon
- Anesthesiology, Intensive Care and Pain Medicine, Catharina Hospital, Eindhoven, The Netherlands.,PeriOperative Care & Technology, Fontys University of Applied Sciences, Eindhoven, The Netherlands
| | - Mohammad Aa Bayoumi
- Women's Wellness and Research Center, Hamad Medical Corporation, Doha, Qatar
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