Letters

Abstract

I am writing concerning an article titled “Neonatal Peripherally Inserted Central Catheters: Recommendations for Prevention of Insertion and Postinsertion Complications,” published in Vol. 27, No. 4 (July/August 2008), pages 245– 257. Of concern are Figures 3 and 4 on page 253 titled securing the catheter with adhesive skin closure strips and looping the catheter. The instructions and pictures demonstrate how to secure the catheter using skin closure strips and show the strips placed over the catheter. This is of great concern. The manufacturer’s recommendations on BD L-Cath System state the following on page 8 line 26, “Secure the catheter and dress the site with a sterile dressing. Tapes and securing devices should never be applied directly to the non-protected catheter.” This caution is echoed in the article titled “Tiny Patients, Tiny Dressings: A Guide to Neonatal PICC Dressing Change,” published in Advances in Neonatal Care, Vol. 8, No. 3, pages 141–162. The author states the following, “Some hospitals use skin closure strips. If these are utilized, manufacturer’s recommendations should be followed, and they should never be placed directly overlying the catheter to avoid catheter breakage and embolism.” The author supports this statement with the following reference, Frey AM. PICC complications in neonates and children. Journal of Vascular Access Devices. 1999: 17–26. It is clear that skin closure strips used to secure the peripherally inserted central catheter pose great risk and must never be applied directly over the catheter. Thank you for sharing this important information with your readers.