Schmutz Axel, Menz Lea, Schumann Stefan, Heinrich Sebastian
Department of Anesthesiology and Critical Care, Medical Center, Faculty of Medicine, University of Freiburg, 79106 Freiburg, Germany.
J Clin Med. 2020 Oct 1;9(10):3192. doi: 10.3390/jcm9103192.
Peripheral intravenous catheters (PIVC) are the most frequently used invasive devices in medicine. PIVC failure before treatment completion is a significant concern and occurs in 33-69% of patients. Partial dislodgement and accidental removal are some of the reasons for PIVC failure. The most effective dressing and securement method for preventing accidental removal remains unclear. It was the aim of this study to compare the force required to dislodge a PIVC with four commonly used dressing and securement methods. Additionally, costs were calculated.
Truncated 18-gauge i.v. cannulas were attached onto the forearm of 209 volunteers using four different dressings and securements (sterile absorbent wound dressing covered by two different types of elastic polyester fleece, bordered and non-bordered polyurethane). The force during continuously stronger pulling until dislodgement was recorded.
The highest resistance against dislodgement forces could be observed with a sterile absorbent wound dressing covered by two incised elastic polyester fleece dressings. Commercially-manufactured bordered and non-bordered polyurethan film dressings were 20% to 75% more expensive than sterile absorbent wound dressings covered by elastic polyester fleece dressing.
Elastic polyester fleece secured a PIVC against accidental removal by external force best, compared to commercially-manufactured bordered and non-bordered polyurethane film dressing.
外周静脉导管（PIVC）是医学中使用最频繁的侵入性装置。在治疗完成前PIVC失败是一个重大问题，33% - 69%的患者会出现这种情况。部分移位和意外拔除是PIVC失败的一些原因。预防意外拔除最有效的敷料和固定方法仍不明确。本研究的目的是比较使用四种常用敷料和固定方法时拔除PIVC所需的力量。此外，还计算了成本。
将截断的18号静脉套管针使用四种不同的敷料和固定方法（两种不同类型的弹性聚酯羊毛覆盖的无菌吸收性伤口敷料、有边框和无边框的聚氨酯）固定在209名志愿者的前臂上。记录持续加大拉力直至导管移位时的力量。
使用两种切开的弹性聚酯羊毛敷料覆盖的无菌吸收性伤口敷料时，观察到对移位力的抵抗力最高。商业生产的有边框和无边框聚氨酯薄膜敷料比弹性聚酯羊毛敷料覆盖的无菌吸收性伤口敷料贵20%至75%。
与商业生产的有边框和无边框聚氨酯薄膜敷料相比，弹性聚酯羊毛能最好地固定PIVC以防止外力意外拔除。
