I have seen at least 2 cases where an IJ cvc was sutured as well as stapled..stapling to me seems babaric and unneccessary, is this a trend or a common practice @ other hospitals??
Several years ago, I was giving a presentation on Stabilization of CVADs and included a few studies on stapling CVADs. 2 studies were done on cadavers and pull-tests were done to see how much force it would take to dislodge the catheter. Last time I checked, a cadever was not moving, so I have issues with using those studies for any real decisions. There was only one clinical study that showed stapling took far less time than suturing, but did not hold the catheter as long. This was a very small study with only about 20 patients. I thought stapling for CVADs had gone by the wayside and no one was doing it any longer. I have never heard of anyone using both sutures and staples. This suggests that they may have been having problems with one then added the other. I think they should investigate a manufacturerd catheter stabilization devices as the best alterative. Lynn
Along the same lines (I think) is a PICC that has "barbs" that project out of the hub area and secure into the patient's subcutaneous tissue. I had to remove one of these catheters and felt that it was barbaric. I shriek to think of a confused patient ripping that out of their skin or the patient that doesn't have adequate adipose. Just one more thing in the marketplace.
Several years ago, I was giving a presentation on Stabilization of CVADs and included a few studies on stapling CVADs. 2 studies were done on cadavers and pull-tests were done to see how much force it would take to dislodge the catheter. Last time I checked, a cadever was not moving, so I have issues with using those studies for any real decisions. There was only one clinical study that showed stapling took far less time than suturing, but did not hold the catheter as long. This was a very small study with only about 20 patients. I thought stapling for CVADs had gone by the wayside and no one was doing it any longer. I have never heard of anyone using both sutures and staples. This suggests that they may have been having problems with one then added the other. I think they should investigate a manufacturerd catheter stabilization devices as the best alterative. Lynn
Lynn Hadaway, M.Ed., RN, BC, CRNI
Lynn Hadaway Associates, Inc.
126 Main Street, PO Box 10
Milner, GA 30257
Website http://www.hadawayassociates.com
Office Phone 770-358-7861
Along the same lines (I think) is a PICC that has "barbs" that project out of the hub area and secure into the patient's subcutaneous tissue. I had to remove one of these catheters and felt that it was barbaric. I shriek to think of a confused patient ripping that out of their skin or the patient that doesn't have adequate adipose. Just one more thing in the marketplace.