A retrospective audit of the surgical insertion and clinical outcome of silastic venous catheters on our Haematology Unit was performed for the period 1985 to 1988. Twenty-three (58%) of the 40 lines had complications, and analysis showed that many were due to problems related to the surgical technique used.
This altered our clinical practice, and over a 12 month period (January 1989 to January 1990) 26 central venous catheters have been placed in 24 patients by a dedicated surgical team using a standardized, altered technique. This has been to place all catheters via the right internal jugular vein and to confirm line position by on-table radiographic screening. A significant improvement in results is presented.
HeimbachD.M., IveyT.D.Technique for placement of a permanent home hyperalimentation catheter. Surg Gynecol Obstet1976; 143: 635–6
2.
CurtasS., BonaventuraM., MeguidM.M.Cannulation of inferior vena cava for long term central venous access. Surg Gynecol Obstet1989; 168: 121–4
3.
ThomasP.R.S., SinnettH.D.An evaluation of prolonged venous access catheters in patients with leukaemia and other malignancies. Eur J Surg Oncol1988; 14: 63–8
4.
ParsaM.H., TaboraF.Establishment of intravenous lines for long term intravenous therapy and monitoring. Surg Clin North Am1985; 66: 835–65
5.
ReedW.P., NewmanK.A.An improved technique for the insertion of Hickman catheters in patients with thrombocytopenia and granulocytopenia. Surg Gynecol Obstet1983; 156: 355–8
6.
WilsonS.E., StabileB.E., WilliamsR.A., OwensM.L.Current status of vascular access techniques. Surg Clin North Am1982: 62: 531–51
7.
FanS.T.A safe technique for the insertion of Hickman catheter into the internal jugular vein. J Parenter Enteral Nutr1988; 12: 223–4
