The S-Tunnel for tunnelled dialysis catheter: an alternative approach to the prevention of displacement.
OBJECTIVE
Vascular access has been described in the literature anywhere from the 'Achilles Heel' to the 'Cornerstone' of haemodialysis. Displacement of a central venous catheter is not an uncommon occurrence. We discuss an alternative method of placement for the tunnelled central venous catheter to prevent displacement in those patients with excess anterior chest wall soft tissue.


METHODS
A new surgical technique for placement of a tunnelled central venous catheter was developed in an attempt to reduce the number of displacements. This involved the creation of a second tunnel at a 90° angle to the original retrograde tunnelled path.


RESULTS
The authors have currently placed five 'S-Line' tunnelled central venous catheters with no reports of displacement or line infection over a period of 18 months.


CONCLUSIONS
The 'S-Line' offers a simple, straightforward and most importantly safe method to reduce the incidence of tunnelled right internal jugular central venous catheter displacement.
City Hospitals Sunderland, Sunderland Royal Hospital, Department of Renal Medicine, Kayll Road, Sunderland - UK.
Glyndwr W
GW
Jenkins
City Hospitals Sunderland, Sunderland Royal Hospital, Department of Renal Medicine, Kayll Road, Sunderland - UK.
Michael
M
Kelly
City Hospitals Sunderland, Sunderland Royal Hospital, Department of Renal Medicine, Kayll Road, Sunderland - UK.
Siddiq
S
Anwar
City Hospitals Sunderland, Sunderland Royal Hospital, Department of Renal Medicine, Kayll Road, Sunderland - UK.
Saeed S
SS
Ahmed
D055499:Catheter-Related Infections / Q000517:prevention & control; D002405:Catheterization, Central Venous / Q000009:adverse effects / Q000295:instrumentation* / Q000379:methods*; D062905:Central Venous Catheters / Q000009:adverse effects; D004867:Equipment Design; D005548:Foreign-Body Migration / Q000517:prevention & control; D006801:Humans; D006435:Renal Dialysis; D013997:Time Factors; D016896:Treatment Outcome