title: Securing central venous catheters: a comparison of sutures with staples.
abstract: OBJECTIVE
  Central venous access permits rapid drug delivery to the central circulation during cardiopulmonary resuscitation. Central venous catheters must be secured in place to prevent accidental removal and sutures are often used for this purpose. Staples may offer advantages over sutures by reducing the time needed to secure the central venous catheter and reducing exposure to contaminated sharps. The purpose of this study was to assess a staple anchoring device (Arrow, Reading, USA) and compare it with sutures for securing central venous catheters.
  
  
  METHODS
  Prospective, randomised trial of 20 patients requiring insertion of a central venous catheter during elective surgery.
  
  
  RESULTS
  Mean (SD) times were significantly shorter in the staples group than in the sutures group (staples 10.1 (3.5) seconds; sutures 50.5 (9.6) seconds; p<0.0001). However, 3 of 10 central venous catheters in the staples group were accidentally pulled out within the first three days.
  
  
  CONCLUSIONS
  The use of staples significantly reduces the time to secure a central venous catheter. However, staples failed to secure the central venous catheters adequately and therefore cannot be recommended instead of sutures.
authors.affiliation: Department of Anaesthetics and Intensive Care, Dumfries and Galloway Royal Infirmary, Bankend Road, Dumfries DG1 4AP, UK.
authors.forename: A
authors.initials: A
authors.lastname: Vinjirayer
authors.forename: P
authors.initials: P
authors.lastname: Jefferson
authors.forename: D R
authors.initials: DR
authors.lastname: Ball
mesh_terms: D002405:Catheterization, Central Venous / Q000379:methods*; D006801:Humans; D007601:Jugular Veins; D016602:Needlestick Injuries / Q000209:etiology / Q000517:prevention & control; D011446:Prospective Studies; D017792:Surgical Stapling / Q000009:adverse effects; D013537:Sutures / Q000009:adverse effects; D013997:Time Factors