title: The retrograde tunnel: a method for the fixation of central venous catheters in the military environment.
abstract: Central venous catheters (CVCs) are prone to accidental removal during patient transportation. Of the casualties who require transfer between medical facilities, those with CVC in situ require additional vigilance to prevent loss of the CVC, which continues to occur despite various methods of fixation. The fashioning of a subcutaneous tunnel has become an integral part of the placement of central venous catheters. Several methods have been described, but the long-term CVCs in paediatric practice pose special problems, particularly that of the patients continually testing the CVCs fixation. Using a new polyurethane CVC, a retrograde tunnelling technique has been developed which affords immediate and secure fixation. We propose that this CVC, together with the technique of retrograde tunnelling, is the solution to inadvertent central venous line removal during patient transfer.
authors.affiliation: Wessex Regional Centre for Paediatric Surgery, Southampton General Hospital.
authors.forename: R A
authors.initials: RA
authors.lastname: Wheeler
authors.forename: T J
authors.initials: TJ
authors.lastname: Spalding
authors.forename: J A
authors.initials: JA
authors.lastname: Thomas
authors.forename: G A
authors.initials: GA
authors.lastname: Carss
mesh_terms: D000293:Adolescent; D002405:Catheterization, Central Venous / Q000295:instrumentation / Q000379:methods*; D002648:Child; D002675:Child, Preschool; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008887:Military Medicine; D010360:Patient Transfer