Effectiveness of different central venous catheter fixation suture techniques: An in vitro crossover study

PURPOSE: Proper fixation of central venous catheters (CVCs) is an integral part of safety to avoid dislodgement and malfunction. However, the effectiveness of different CVC securement sutures is unknown. METHODS: Analysis of maximum dislodgement forces for CVCs from three different manufacturers using four different suture techniques in an in vitro tensile loading experiment: 1. “clamp only”, 2. “clamp and compression suture”, 3. “finger trap” and 4. “complete”, i.e., “clamp + compression suture + finger trap”. Twenty-five tests were performed for each of the three CVC models and four securement suture techniques (n = 300 test runs). RESULTS: The primary cause of catheter dislodgement was sliding through the clamp in techniques 1 and 2. In contrast, rupture of the suture was the predominant cause for dislodgement in techniques 2 and 3. Median (IQR 25–75%) dislodgement forces were 26.0 (16.6) N in technique 1, 26.5 (18.8) N in technique 2, 76.7 (18.7) N in technique 3, and 84.8 (11.8) N in technique 4. Post-hoc analysis demonstrated significant differences (P < .001) between all pairwise combinations of techniques except technique 1 vs. 2 (P = .98). CONCLUSIONS: “Finger trap” fixation at the segmentation site considerably increases forces required for dislodgement compared to clamp-based approaches.