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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 2024; 25:1238-1243. [PMID: 36856232 DOI: 10.1177/11297298231159177] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [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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Kurata Y, Ohira G, Hayano K, Imanishi S, Tochigi T, Takahashi Y, Mamiya H, Iwata M, Uesato M, Murakami K, Toyozumi T, Matsumoto Y, Nakano A, Otsuka R, Hayashi H, Matsubara H. Peripherally inserted central catheter securement with cyanoacrylate glue and bloodstream infection: A retrospective cohort study. JPEN J Parenter Enteral Nutr 2024; 48:215-223. [PMID: 38047542 DOI: 10.1002/jpen.2583] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2023] [Revised: 11/06/2023] [Accepted: 11/28/2023] [Indexed: 12/05/2023]
Abstract
BACKGROUND Treatment via a peripherally inserted central venous catheter is important for anticancer treatment, perioperative management, and nutrition management. In this study, we aimed to investigate the usefulness of cyanoacrylate glue (CG) in managing peripherally inserted central venous catheters in adults. METHODS This retrospective cohort study enrolled 411 adults requiring a central venous catheter for treatment in the Chiba University Esophageal-Gastro-Intestinal Surgery department between January 2021 and October 2022. The preventive effect of CG in reducing adverse events, including infection, tip migration, and thrombus formation, was evaluated by reviewing electronic medical records, chest radiographs, and contrast-enhanced computed tomography scans. RESULTS CG and other dressings were used in 158 (CG group) and 253 (control group) patients, respectively. The incidence of catheter infection based on the clinical course was lower in the CG group (3.2%) than in the control group (9.1%; P = 0.03). However, cases of infection confirmed by blood or catheter cultures did not differ between the CG (1.3%) and control (1.9%) groups (P = 1.0). Chest radiographs revealed that catheter tip migration (mean ± SD) was lesser in the CG group (8.2 ± 6.7 mm) than in the control group (15.0 ± 15.8 mm; P < 0.01). There were two cases of venous thrombus formation in the control group. CONCLUSION In a population dominated by esophago-gastroenterological malignancy, peripherally inserted central catheter securement via CG was associated with decreased catheter removal because of suspected catheter infection. Further research on larger cohorts is needed to determine if other adverse events decrease following peripherally inserted central catheter securement via CG.
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Affiliation(s)
- Yoshihiro Kurata
- Department of Frontier Surgery, Graduate School of Medicine, Chiba University, Chiba, Japan
| | - Gaku Ohira
- Department of Frontier Surgery, Graduate School of Medicine, Chiba University, Chiba, Japan
| | - Koichi Hayano
- Department of Frontier Surgery, Graduate School of Medicine, Chiba University, Chiba, Japan
| | - Shunsuke Imanishi
- Department of Frontier Surgery, Graduate School of Medicine, Chiba University, Chiba, Japan
| | - Toru Tochigi
- Department of Frontier Surgery, Graduate School of Medicine, Chiba University, Chiba, Japan
| | - Yumiko Takahashi
- Department of Frontier Surgery, Graduate School of Medicine, Chiba University, Chiba, Japan
| | - Hisashi Mamiya
- Department of Frontier Surgery, Graduate School of Medicine, Chiba University, Chiba, Japan
| | - Moe Iwata
- Department of Frontier Surgery, Graduate School of Medicine, Chiba University, Chiba, Japan
| | - Masaya Uesato
- Department of Frontier Surgery, Graduate School of Medicine, Chiba University, Chiba, Japan
| | - Kentaro Murakami
- Department of Frontier Surgery, Graduate School of Medicine, Chiba University, Chiba, Japan
| | - Takeshi Toyozumi
- Department of Frontier Surgery, Graduate School of Medicine, Chiba University, Chiba, Japan
| | - Yasunori Matsumoto
- Department of Frontier Surgery, Graduate School of Medicine, Chiba University, Chiba, Japan
| | - Akira Nakano
- Department of Frontier Surgery, Graduate School of Medicine, Chiba University, Chiba, Japan
| | - Ryota Otsuka
- Department of Frontier Surgery, Graduate School of Medicine, Chiba University, Chiba, Japan
| | | | - Hisahiro Matsubara
- Department of Frontier Surgery, Graduate School of Medicine, Chiba University, Chiba, Japan
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Xu H, Hyun A, Mihala G, Rickard CM, Cooke ML, Lin F, Mitchell M, Ullman AJ. The effectiveness of dressings and securement devices to prevent central venous catheter-associated complications: A systematic review and meta-analysis. Int J Nurs Stud 2024; 149:104620. [PMID: 37879273 DOI: 10.1016/j.ijnurstu.2023.104620] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2023] [Revised: 09/25/2023] [Accepted: 10/04/2023] [Indexed: 10/27/2023]
Abstract
BACKGROUND Central venous catheters are commonly used in healthcare, but they come with a range of potential complications. Over the last 15 years, an influx of securement and dressing products has been released, with unknown overall effectiveness to prevent these complications. OBJECTIVE To compare the effects of dressings and securement devices for central venous catheters on a range of common complications including catheter-related bloodstream infection, catheter tip colonisation, entry/exit-site infection, skin colonisation, skin irritation, failed catheter securement, dressing durability and mortality. DESIGN Systematic review with meta-analysis. METHODS Following standard Cochrane methods, a systematic search of Cochrane Wounds Trials Register, Cochrane Central Register of Controlled Trials, MEDLINE Ovid, Embase Ovid, EBSCO CINAHL, and multiple clinical trial registries was completed in November 2022. Randomised controlled trials evaluating the effectiveness of dressing and securement devices for all CVC types were included. A random-effects model was used during the meta-analysis. Results were expressed using risk ratio (RR), rate ratio, or mean difference (MD), with 95 % confidence intervals (CIs). Methodological quality and bias were assessed. RESULTS We included 46 studies involving 10,054 participants. All studies had either an unclear or high-performance bias. The blinding of outcome assessment was unclear in most studies. Chlorhexidine gluconate-impregnated dressings, compared with standard polyurethane dressings, may reduce the incidence (7 studies; N = 5816; RR 0.60, 95 % CI 0.44-0.83; low certainty evidence) and rate (4 studies; N = 4447; RR 0.51, 95 % CI 0.32-0.79; moderate certainty evidence) of catheter-related bloodstream infection and catheter tip colonisation (8 studies; N = 4788; RR 0.70, 95 % CI 0.52-0.95; very low certainty evidence). Medication-impregnated dressings may reduce the incidence of catheter-related bloodstream infection (6 studies; N = 5687; RR 0.60, 95 % CI 0.39-0.93; low certainty evidence) and catheter-tip colonisation (7 studies; N = 4769; RR 0.60, 95 % CI 0.47-0.76; low certainty evidence) relative to non-impregnated dressing types. Tissue adhesive may increase the risk of skin irritation or damage compared with integrated securement dressings (3 studies; N = 166; RR 1.88, 95 % CI 1.09-3.24; low certainty evidence) or sutureless securement devices (4 studies; N = 241; RR 1.64, 95 % CI 1.10-2.44; moderate certainty evidence). Tissue adhesive increased dressing durability compared with integrated securement dressings (MD 43.03 h, 95 % CI 4.88-81.18; moderate certainty evidence) and sutureless securement devices (MD 42.90 h, 4.64-81.16; moderate certainty evidence). Tissue adhesive increased failed catheter securement rate compared with suture (2 studies; N = 103; RR 9.33, 95 % CI 1.10-79.21; moderate certainty evidence). CONCLUSIONS The findings of the review provide insights and guidance for clinicians in selecting the appropriate dressings and securements for catheters. Findings should be interpreted with caution due to heterogeneity in catheters and patient types. REGISTRATION #CD010367. TWEETABLE ABSTRACT Time to implement chlorhexidine gluconate-impregnated dressings to prevent catheter-related bloodstream infections; a meta-analysis by @GraceNP and team.
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Affiliation(s)
- Hui Xu
- NHMRC Centre of Research Excellence in Wiser Wound Care, Menzies Health Institute Queensland, Griffith University, Nathan, Brisbane, QLD, Australia; School of Nursing and Midwifery, Queensland University of Technology, Kelvin Grove, Brisbane, QLD, Australia; Nursing and Midwifery Research Centre, Royal Brisbane and Women's Hospital, Butterfield St, Herston, Brisbane, QLD, Australia; Alliance for Vascular Access Teaching and Research (AVATAR), Schools of Nursing and Midwifery and Pharmacy and Medical Sciences, Griffith University, Nathan, Brisbane, QLD, Australia.
| | - Areum Hyun
- School of Nursing, Midwifery and Social Work, University of Queensland, St Lucia, Brisbane, QLD, Australia
| | - Gabor Mihala
- The Australasian Kidney Trials Network, Centre for Health Services Research, The University of Queensland, Woolloongabba, QLD, Australia
| | - Claire M Rickard
- NHMRC Centre of Research Excellence in Wiser Wound Care, Menzies Health Institute Queensland, Griffith University, Nathan, Brisbane, QLD, Australia; Nursing and Midwifery Research Centre, Royal Brisbane and Women's Hospital, Butterfield St, Herston, Brisbane, QLD, Australia; Alliance for Vascular Access Teaching and Research (AVATAR), Schools of Nursing and Midwifery and Pharmacy and Medical Sciences, Griffith University, Nathan, Brisbane, QLD, Australia; School of Nursing, Midwifery and Social Work, University of Queensland, St Lucia, Brisbane, QLD, Australia; Herston Infectious Diseases Institute, Metro North Health, Herston, QLD 4006, Australia.
| | - Marie L Cooke
- Alliance for Vascular Access Teaching and Research (AVATAR), Schools of Nursing and Midwifery and Pharmacy and Medical Sciences, Griffith University, Nathan, Brisbane, QLD, Australia
| | - Frances Lin
- College of Nursing and Health Sciences, Flinders University, Bedford Park, SA, Australia; School of Health, University of the Sunshine Coast, QLD, Australia
| | - Marion Mitchell
- School of Nursing and Midwifery, Griffith University, Nathan, Brisbane, QLD, Australia
| | - Amanda J Ullman
- NHMRC Centre of Research Excellence in Wiser Wound Care, Menzies Health Institute Queensland, Griffith University, Nathan, Brisbane, QLD, Australia; Alliance for Vascular Access Teaching and Research (AVATAR), Schools of Nursing and Midwifery and Pharmacy and Medical Sciences, Griffith University, Nathan, Brisbane, QLD, Australia; School of Nursing, Midwifery and Social Work, University of Queensland, St Lucia, Brisbane, QLD, Australia; Centre for Child Health Research, Children's Health Queensland Hospital and Health Service, Brisbane, QLD, Australia.
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A Revolutionary, Proven Solution to Vascular Access Concerns: A Review of the Advantageous Properties and Benefits of Catheter Securement Cyanoacrylate Adhesives. JOURNAL OF INFUSION NURSING 2022; 45:154-164. [PMID: 35537003 DOI: 10.1097/nan.0000000000000467] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
Intravascular catheters are widely used among hospitals; however, their failure rates are high, up to 50%, when secured by traditional techniques, such as tape and gauze. The use of catheter securement cyanoacrylate adhesives provides a unique approach to the issues surrounding the use of traditional securement techniques for vascular access devices by providing significant securement strength, barrier properties, antibacterial properties, hemostatic properties, and flexibility. The purpose of this research was to perform a thorough and systematic review of the current literature existing regarding the use of cyanoacrylate adhesive for the care and maintenance of vascular access devices.
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Gilardi E, Piano A, Chellini P, Fiori B, Dolcetti L, Pittiruti M, Scoppettuolo G. Reduction of bacterial colonization at the exit site of peripherally inserted central catheters: A comparison between chlorhexidine-releasing sponge dressings and cyano-acrylate. J Vasc Access 2020; 22:597-601. [PMID: 32883154 DOI: 10.1177/1129729820954743] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023] Open
Abstract
INTRODUCTION A serious complication associated with Central Venous Access Device (CVAD) is infection because of bacterial contamination, either by the extra-luminal or by the intra-luminal route.We evaluated the efficacy, the safety, and the cost-effectiveness of two strategies for non-inferiority in controlling bacterial colonization of the exit-site of Peripherally-Inserted Central Catheters (PICC). METHODS After PICC placement, a skin swab of the exit site was taken and cultured. In group A the exit site was sealed with N-butyl-cyanoacrylate glue, while in group B a chlorhexidine-releasing sponge dressing was applied. A second skin culture was taken at day 7. RESULTS A total of 51 patients were enrolled in each group. In 42 patients the second skin culture was not performed because of 20 patients were lost at follow-up or deceased and in 22 patients the dressing needed to be changed early, because of local bleeding (13 cases, in group B) or because of dressing detachment (four in group A and five in group B). The microbiological study was completed in 36 patients in group A and 24 in group B. No microorganisms were isolated in any patient. CONCLUSIONS Both strategies were effective in controlling bacterial colonization. Glue was effective in reducing local bleeding, and it was more cost-effective than sponge dressing. During the first week, when local bleeding and bacterial colonization must be prevented, glue might be more appropriate than chlorhexidine-releasing dressing; after the first week chlorhexidine-releasing dressing might be preferable, considering that the safety of glue application on the skin for prolonged periods is still questionable.
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Affiliation(s)
- Emanuele Gilardi
- Department of Emergency Medicine, Fondazione Policlinico Universitario "A. Gemelli" IRCCS, Rome, Italy
| | - Alfonso Piano
- Department of Emergency Medicine, Fondazione Policlinico Universitario "A. Gemelli" IRCCS, Rome, Italy
| | - Pietro Chellini
- Department of Emergency Medicine, Fondazione Policlinico Universitario "A. Gemelli" IRCCS, Rome, Italy
| | - Barbara Fiori
- Department of Laboratory and Infectious Science, Fondazione Policlinico Universitario "A. Gemelli" IRCCS, Rome, Italy
| | - Laura Dolcetti
- Department of Infectious Diseases, Fondazione Policlinico Universitario "A. Gemelli" IRCCS, Rome, Italy
| | - Mauro Pittiruti
- Department of Emergency Surgery Fondazione Policlinico Universitario "A. Gemelli" IRCCS, Rome, Italy
| | - Giancarlo Scoppettuolo
- Department of Infectious Diseases, Fondazione Policlinico Universitario "A. Gemelli" IRCCS, Rome, Italy
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