Skin fold technique for central venous catheter fixation; comparison with conventional method for post-op infection

Central Venous Catheters (CVCs) are used not only as an access to central venous system, but also for hemodynamic monitoring, parenteral nutrition, chemotherapy and hemodialysis. The use of central venous catheters is associated with some complications notably infections that are troublesome both to patient and physician. We conducted this study to examine catheter fixation with skin fold technique and evaluated risk of catheter infection in this method and compared it to conventional technique. This study is a controlled clinical trial and cases are all the patients over 18 years, admitted to Hashemi-Nejhad kidney center from 2011 to 2012, who needed an internal jugular venous catheter for hemodialysis. Two hundred and twenty two patients entered the study. Patients were randomly divided to skin fold suturing (127 patients) and standard suturing (95 patients) groups. Chi – square test and logistic regression were used for data analysis. P value less than 0.05 was considered to be significant. The mean age of patients in skin fold suturing and standard suturing groups were 54.5±16.43 and 54.4±14.84 years, respectively. The rate of catheter infection significantly decreased (mean difference=13%) with skin fold technique (3%) in comparison to standard suturing group (p=0.002). The findings of this survey demonstrated that catheter fixation with skin fold could be an appropriate technique in comparison with current conventional method. However, further studies on other possible and unpredictable complications of this technique is required.