Repeated rescue of a Broviac catheter: fixation of exposed cuff by a skin flap.
A cutaneous infection exposed the cuff of a Broviac catheter employed for home-TPN in a 3-month-old child with ultra-short bowel syndrome. In order to avoid removal of the catheter, sepsis was abated by antibiotic administration through its lumen, then the exposed cuff was covered and fixed by a skin flap. The advantages proceeding from this sort of "emergency rescue" of the Broviac catheter have been: (1) to avoid a new cutdown in a child already submitted to several attempts of cannulation with sacrifice of major vessels; (2) to resume home total parenteral nutrition (TPN) in a short time, being the patient strictly dependent upon his parenteral intake and to spare a well-functioning catheter. Ten months after the last cuff covering by skin flap, the catheter is safely fixed in place and currently employed for home TPN.
D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D002404:Catheterization; D006701:Home Nursing; D006801:Humans; D007223:Infant; D008297:Male; D010289:Parenteral Nutrition, Total / Q000295:instrumentation*; D012874:Skin Diseases, Infectious / Q000188:drug therapy; D016038:Skin Transplantation; D013524:Surgical Flaps
D000900:Anti-Bacterial Agents