Long-term indwelling silastic central venous catheters: clinical audit leading to improved surgical technique.
A retrospective audit of the surgical insertion and clinical outcome of silastic venous catheters on our Haematology Unit was performed for the period 1985 to 1988. Twenty-three (58%) of the 40 lines had complications, and analysis showed that many were due to problems related to the surgical technique used. This altered our clinical practice, and over a 12 month period (January 1989 to January 1990) 26 central venous catheters have been placed in 24 patients by a dedicated surgical team using a standardized, altered technique. This has been to place all catheters via the right internal jugular vein and to confirm line position by on-table radiographic screening. A significant improvement in results is presented.
Dennis
M J
MJ
Department of Surgery, City Hospital, Nottingham.
Hunter
A E
AE
Ryan
J J
JJ
D000293:Adolescent; D000328:Adult; D000368:Aged; D002405:Catheterization, Central Venous / Q000009:adverse effects / Q000295:instrumentation* / Q000379:methods / Q000706:statistics & numerical data; D002408:Catheters, Indwelling / Q000706:statistics & numerical data*; D004739:England / Q000453:epidemiology; D004867:Equipment Design; D013502:General Surgery; D006801:Humans; D007601:Jugular Veins / Q000601:surgery; D008485:Medical Audit; D008505:Medical Staff, Hospital; D008875:Middle Aged; D012189:Retrospective Studies; D012826:Silicone Elastomers; D012828:Silicones; D013503:Surgery Department, Hospital; D013927:Thrombosis / Q000453:epidemiology; D013997:Time Factors; D014683:Vena Cava, Superior
D012826:Silicone Elastomers; D012828:Silicones