title: A new Subcutaneously Anchored Device for Securing External Cerebrospinal Fluid Catheters: our Preliminary Experience.
abstract: BACKGROUND
  Accidental dislocation or removal is a well-known complication of external cerebrospinal fluid (CSF) drainage in daily clinical practice. At present, no data about the incidence of such complications are available in the scientific literature. SecurAcath (Interrad Medical, Plymouth, Minnesota, USA) is a subcutaneously anchored device recently adopted for securement of central venous catheters, known to be highly effective (and cost-effective) in reducing the risk of catheter dislodgement and/or accidental removal.
  
  
  METHODS
  We report our preliminary experience with the use of SecurAcath to secure CSF drainage, either ventricular or spinal, to the skin.
  
  
  RESULTS
  SecurAcath was used in 29 consecutive patients (age range: 3 weeks-16 years, median age 6.3 years). In particular, the device was used for 25 ventricular catheters (a patient received 2 catheters in the same procedure for bilateral brain abscess) and 5 spinal drainages. Period in place ranged from 1-4 weeks (median 22 days). No complication related to the use of the device was observed, in particular there was no case of dislocation or accidental removal of the catheter. The removal procedure was extremely easy. The device has proven its utility also in 3 cases requiring an adjustment of the length of the catheter.
  
  
  CONCLUSIONS
  In our experience, SecurAcath is a safe and effective device to secure CSF external catheters to the skin, with several relevant advantages: its placement and maintenance are easy; it may stay in place for the entire duration of the catheter; it allows a more complete antisepsis of the exit site, thus reducing local skin complications; it eliminates the risk of suture-related needlestick injuries.
authors.affiliation: Pediatric Neurosurgery, Catholic University Medical School, Rome, Italy. Electronic address: paolo.frassanito@gmail.com.
authors.forename: Paolo
authors.initials: P
authors.lastname: Frassanito
authors.affiliation: Pediatric Neurosurgery, Catholic University Medical School, Rome, Italy.
authors.forename: Luca
authors.initials: L
authors.lastname: Massimi
authors.affiliation: Pediatric Neurosurgery, Catholic University Medical School, Rome, Italy.
authors.forename: Gianpiero
authors.initials: G
authors.lastname: Tamburrini
authors.affiliation: Department of Surgery, Catholic University Medical School, Rome, Italy.
authors.forename: Mauro
authors.initials: M
authors.lastname: Pittiruti
authors.affiliation: Neurosurgery Unit, Department of Medical and Surgical Specialities, Radiological Sciences and Public Health, University of Brescia, Brescia, Italy.
authors.forename: Francesco
authors.initials: F
authors.lastname: Doglietto
authors.affiliation: Neurosurgery Unit, Department of Medical and Surgical Specialities, Radiological Sciences and Public Health, University of Brescia, Brescia, Italy.
authors.forename: Carlotta Ginevra
authors.initials: CG
authors.lastname: Nucci
authors.affiliation: Pediatric Neurosurgery, Catholic University Medical School, Rome, Italy.
authors.forename: Massimo
authors.initials: M
authors.lastname: Caldarelli
mesh_terms: D000293:Adolescent; D002406:Catheterization, Peripheral / Q000295:instrumentation* / Q000379:methods; D002408:Catheters, Indwelling; D002557:Cerebrospinal Fluid Shunts / Q000295:instrumentation* / Q000379:methods*; D002648:Child; D002675:Child, Preschool; D004867:Equipment Design; D019544:Equipment Failure Analysis; D005260:Female; D006801:Humans; D006849:Hydrocephalus / Q000628:therapy*; D008297:Male; D010865:Pilot Projects; D013536:Suture Techniques / Q000295:instrumentation*; D016896:Treatment Outcome
keywords: CSF catheter; External ventricular drainage; Skin anchor; Skin securement; Spinal drainage ventricular catheter