Evaluation of a sutureless securement device (SecurAcath) for PICCs compared with sutures at a tertiary paediatric centre  

AIMS

Current options for PICC securement include adhesive devices (such as StatLock and Grip-Lok), adhesive-strips and sutures (stitches). Adhesive devices require weekly changes and are currently not available at our institution. Experience with these in children is that the PICC is often at high risk of accidental removal during dressing changes. Sutures are often used to mitigate this risk and are the standard method for securement in our institution.

 

METHODS

We performed a service evaluation in 10 patients having PICCs secured using sutures, versus 10 patients having PICCs secured with a SecurAcath device. The patients had PICCs with an intended dwell time of over two weeks. The outcomes measured were displacement, migration, infection, skin damage, pain at site, ease of dressing change, ease of removal and completion of treatment.

RESULTS

The evaluation was carried out over a period of five months with patients ranging from 5 weeks to 17 years of age. In the SecurAcath group there were no recorded displacements or migrations whilst in the suture group, two patients suffered line migration, one of whom did not complete treatment as a consequence of the migration. Three other patients did not complete treatment for other reasons, including line occlusion or breakage. There were no cases of skin damage or significant pain at the site of securement in both groups.

CONCLUSIONS

We have evaluated the case for adopting SecurAcath in our institution for securing PICCs. We found SecurAcaths easy to insert, well tolerated and associated with a low incidence of catheter-related complications with less displacement compared to sutures.