Central Venous Catheter Management by Using a Silk Thread Suture-Free Device with 70% Alcohol

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  • ７０％アルコール・絹糸縫合不要なデバイスによる中心静脈カテーテル管理についての報告
  • 70% アルコール キヌイト ホウゴウ フヨウナ デバイス ニ ヨル チュウシン ジョウミャク カテーテル カンリ ニ ツイテ ノ ホウコク

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Abstract

  Our ward is a facility for mixed management of hematopoietic malignancy and cardiovascular diseases.Central venous catheters (CVCs) are used in various medical situations for patients undergoing anticancer chemotherapy including pretransplantation management and patients with acute cardiovascular disease. The duration of CVC indwelling is generally long. Silk sutures are used to anchor the CVC to the skin at insertion. Previous antiseptic procedures used povidone iodine, which was often associated with red skin rashes at the insertion/suture site and detachment of dressing agent.<br>   Povidone iodine takes time to dry and hypoalcohol is used to observe the insertion site. Changing dressings is both time- and labor-consuming. A CVC device not requiring silk sutures was introduced together with disinfection using 70% alcohol and more elastic and sweat-absorbent dressings for some patients. A survey of the occurrence of CVC-related blood stream infection (CVC-BSI) confirmed no increase in the incidence of CVC-BSI after the change to CVC and management from February to May 2006.<br>   The revised antiseptic agent and dressing has been used for all patients since June 2006, and another survey was carried out (different fixation methods are employed currently). Five episodes of CVC-BSI were observed in patients under antiseptic management with povidone iodine and hypoalcohol (8/1000 patients) before the introduction of revised CVC management. No episodes of CVC-BSI were seen in patients managed under the new procedures. After changing the antiseptic management in all patients, 5 episodes of CVC-BSI were reported in 2/1000 patients, indicating no increase in the incidence of CVC-BSI. Red skin rash was observed in 16 of 48 patients treated with CVC with silk sutures, but none in patients undergoing CVC requiring no silk sutures.<br>

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