A Comparison of Open and Closed Catheterization Techniques in Rehabilitation Patients

Abstract

An effective method was sought to decrease the incidence of urinary tract infections acquired by hospitalized rehabilitation patients requiring catheterization. The purpose of this study was to determine whether there was a difference in the incidence of urinary tract infections that occurred following use of two types of intermittent catheterization techniques: open catheterization and closed catheterization. The incidence of infection in both the control (open catheterization) and experimental (closed catheterization) groups was analyzed. In the control group, 9 of 14 patients (5 stroke, 4 spinal cord injured [SCI]) completed all four urine tests. Two patients developed a 20,000 colony count of enterococcus on the fourth urine sample using open catheterization. In the experimental group, 11 (4 stroke, 7 SCI) out of 16 patients maintained colony counts below 100,000 organisms per ml; one patient had a 16,000 colony count using closed catheterization. Qualitative data revealed that patients had a positive response to the closed system.

Intermittent catheterisation for long‐term bladder management (abridged cochrane review)

“…Five of the six RCTs reported symptomatic UTI using aseptic technique in one arm . All had wide confidence intervals with no apparent trend favoring either technique.…”

“…Five of the six RCTs reported symptomatic UTI using aseptic technique in one arm. 19,[22][23][24][25] All had wide confidence intervals with no apparent trend favoring either technique. None showed statistically significant difference in weeks to onset of UTI.…”

Neurological patients need evidence‐based urological care

“…Four trials compared sterile coated catheter with sterile technique versus sterile uncoated PVC catheter with sterile technique. Three of these included a closed integrated all-in-one catheter and drainage bag system compared to sterile catheter and sterile drainage tray [38][39][40] 43 both reported a slightly lower incidence of microscopic hematuria with the coated catheter and a subject preference for the coated catheter. Another trial compared a single use PVC catheter with hydrophilic coated catheter with both arms using clean technique in SCI patients in rehabilitation.…”

Current Evidence on Intermittent Catheterization

“…Three trials [13][14][15] fit into this category, with a combined a total of 49 subjects. Day and colleagues 14 and Quigley and associates 15 evaluated a closed, integrated, prelubricated catheter and drainage bag system (closed system) compared to using a sterile catheter with a sterile drainage tray (open system).…”