Comparison of staples vs suturing for securing central venous catheters.
OBJECTIVE
To determine whether skin staples can be used to secure central venous catheters as effectively as does suturing.


METHODS
A prospective, randomized trial of techniques to secure a central venous catheter was performed in a medical school human anatomy laboratory using human cadavers. Central lines were secured to the upper left thorax using either standard suture material (000 silk) or skin staples (5.7 mm x 3.8 mm). Once secured, an upward force was applied to the hub of the catheter perpendicular to the skin. The amount of force needed to break the catheter hub free of the skin was measured in kg. A total of 10 measurements were made for each of 3 methods for securing the catheters (2 sutures, 2 staples, 4 staples). In addition, the site of catheter breakage was recorded.


RESULTS
Those catheter hubs secured by 2 sutures required a mean force of 3.1 +/- 0.5 kg to cause breakage, and the break always occurred at the suture. Those hubs secured by 2 staples gave way at 3.0 +/- 0.3 kg (p = NS), while those secured with 4 staples gave way at 4.5 +/- 1.4 kg (p < 0.05). Although 1 hub did break, in all other stapled cases, the break occurred at the staple.


CONCLUSIONS
Based on this cadaver model, use of staples appears to be as effective as suturing for securing central venous catheters. Further studies of safety and time for placement are needed.
Hightower
D
D
Pitt County Memorial Hospital, East Carolina University School of Medicine, Department of Emergency Medicine, Greenville, NC, USA.
March
J
J
Ausband
S
S
Brown
L H
LH
D002102:Cadaver; D002405:Catheterization, Central Venous / Q000295:instrumentation*; D004868:Equipment Failure; D006801:Humans; D016602:Needlestick Injuries / Q000517:prevention & control; D011446:Prospective Studies; D017792:Surgical Stapling / Q000592:standards*; D013537:Sutures / Q000592:standards*; D013718:Tensile Strength