Yokota Taisuke, Tokumine Joho, Lefor Alan Kawarai, Hasegawa Ayako, Yorozu Tomoko, Asao Takayuki
Department of Anesthesiology, Kyorin University School of Medicine, Tokyo.
Department of Surgery, Jichi Medical University, Tochigi-ken.
Medicine (Baltimore). 2019 Jan;98(3):e14208. doi: 10.1097/MD.0000000000014208.
Obtaining venous access in a patient with extensive postburn scar contractures is a challenge.
A 39-year-old woman suffered a burn 2 years previously with a total body surface area burn of 93%, and a burn index of 85. Reconstructive surgery was previously performed 39 times. Split-thickness skin grafting to the neck was planned. She had no accessible peripheral veins.
Difficult venous access due to excessive burn scar contractures.
Central venous catheterization was considered impossible even with ultrasound guidance. We placed a midline catheter for intraoperative venous access in a patient with extensive burn scar contractures. The midline catheter is a peripheral venous catheter placed in an arm vein.
We successfully placed a midline catheter in the right brachial vein. This catheter was used for 24 days without difficulty.
The midline catheter is a viable choice in patients with difficult vascular access due to extensive postburn scar contractures.
在有广泛烧伤后瘢痕挛缩的患者中获得静脉通路是一项挑战。
一名39岁女性在2年前遭受烧伤，全身表面积烧伤达93%，烧伤指数为85。此前已进行39次重建手术。计划对颈部进行中厚皮片移植。她没有可触及的外周静脉。
由于烧伤瘢痕挛缩过度导致静脉通路困难。
即使在超声引导下，中心静脉置管也被认为不可能。我们为一名有广泛烧伤瘢痕挛缩的患者放置了一根中线导管用于术中静脉通路。中线导管是放置在手臂静脉中的外周静脉导管。
我们成功地在右肱静脉放置了一根中线导管。该导管顺利使用了24天。
对于因广泛烧伤后瘢痕挛缩导致血管通路困难的患者，中线导管是一种可行的选择。
