Management, clinical outcomes, and complications of acute cannula-related peripheral vein phlebitis of the upper extremity: A retrospective study.
OBJECTIVE
Acute phlebitis due to peripheral vein catheter use is frequently observed in clinical practice, and requires surgical therapy in severe cases. In this retrospective study, we aimed to increase awareness, evaluate current treatment options, and develop recommendations to optimize treatment outcomes.


METHODS
A total of 240 hospitalized patients with a diagnosis of upper extremity phlebitis from 2006 to 2011 were evaluated in terms of initial clinical features, parameters, co-morbidities and treatment regimes. Severity of phlebitis was graded according to the Baxter scale by assessing clinical symptoms such as pain, erythema, induration, swelling, or palpable venous cord (grade 0-5). Patients were divided in two subgroups: conservative (n = 132) and operative (n = 108) treatment.


RESULTS
Surgical intervention rates and severity were higher for cannula insertion in the cubital fossa region than for cannula insertion in the forearm and hand region (p < 0.05). Baxter scale grades were higher in the surgical treatment group than in the conservative treatment group (4.47 vs. 2.67, respectively).


CONCLUSIONS
The cubital fossa region is vulnerable to severe phlebitis and is not recommended as the first site of choice for cannulation. Phlebitis of Baxter scale grade 4 or 5 should be considered for early surgical intervention.
Department of Plastic Surgery and Hand Surgery, Burn Center, RWTH University Hospital, Aachen, Germany sdunda@ukaachen.de.
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SE
Dunda
Department of Plastic and Reconstructive Surgery, Burn Center, University of Witten/Herdecke, Cologne-Merheim Medical Center (CMMC), Cologne, Germany.
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E
Demir
Department of Plastic Surgery and Hand Surgery, Burn Center, RWTH University Hospital, Aachen, Germany.
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OJ
Mefful
Department of Plastic Surgery and Hand Surgery, Burn Center, RWTH University Hospital, Aachen, Germany.
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G
Grieb
Department of Plastic Surgery and Hand Surgery, Burn Center, RWTH University Hospital, Aachen, Germany.
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A
Bozkurt
Department of Plastic Surgery and Hand Surgery, Burn Center, RWTH University Hospital, Aachen, Germany.
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N
Pallua
D000208:Acute Disease; D002406:Catheterization, Peripheral / Q000009:adverse effects*; D057785:Catheters / Q000009:adverse effects*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010689:Phlebitis / Q000209:etiology / Q000628:therapy*; D012189:Retrospective Studies; D034941:Upper Extremity / Q000098:blood supply
Peripheral catheters; complications; thrombophlebitis; upper extremity; vein