The Effects of Quercetin Topical Cream on Phlebitis Caused by Peripheral Intravenous Catheters: A Randomized Controlled Trial

Abstract

Background: Phlebitis is among the most common complications of intravenous therapy. It significantly correlates with the length of hospital stay and mortality rate. Objectives: This study sought to examine the effects of quercetin topical cream on phlebitis caused by peripheral intravenous catheters. Methods: This single-blind randomized controlled trial was done in 2015 on 66 patients hospitalized at the internal medicine ward of Valiasr (PBUH) hospital, Birjand, Iran. The patients were conveniently recruited and randomly allocated to a control and an experimental group. The data collection tool was a five-point phlebitis assessment scale. As soon as the symptoms of phlebitis were observed, the related catheter was removed and the catheter insertion site was treated every twelve hours for 72 hours with either 2% quercetin cream (the experimental group) or a eucerin-based cream (the control group). Friedman, Wilcoxon and Mann-Whitney U tests were run using the SPSS software for data analysis (v. 14.0). Results: There was no significant difference between the groups regarding patients' age (P = 0.068) and gender (P = 0.69). No significant changes were observed in the severity of phlebitis in the control group during the 72-hour course of the study. However, in the quercetin group, the severity of phlebitis decreased significantly after twelve hours from the beginning of the intervention and the trend of its variations was downward (P < 0.001). Consequently, after 72 hours (or six episodes of quercetin cream use), 90% of all phlebitis cases achieved complete recovery without any side effect. Conclusions: 2% Quercetin cream could be effective in treating phlebitis caused by intravenous catheters and can be used as a useful and safe treatment modality for phlebitis management. The positive effects of quercetin on phlebitis appear very soon after its use.

Practical view of the topical treatment of peripheral venous catheter‐related phlebitis: A scoping review

“…Application of the ointment‐based treatment was by massage and dressing. The calendula was applied by massage 3 times a day for 3 days (Jourabloo et al, 2017), the aloe vera with a gauze dressing twice a day for 2 days (Vidhya, 2017) and the quercetin with a sterile dressing twice a day for 3 days (Ghorbani et al, 2016).…”

“…50% present a low risk of bias in the generation of random sequences, though it should be noted that 12 of the included studies were quasi‐RCT and 2 pre‐experimental. Allocation concealment (selection bias) only took place in three of the studies (Bigdeli Shamloo et al, 2019; Ghorbani et al, 2016; Selva Grace et al, 2020). A similar situation of uncertainty is found in the blinding of participants and personnel (performance bias), which is only described in 4 of the studies (Basu et al, 2017; Ghorbani et al, 2016; Selva Grace et al, 2020; Sharma, 2016), and in the blinding of results assessment (detection bias), which is reported in just 3 studies (Basu et al, 2017; Bigdeli Shamloo et al, 2019; Selva Grace et al, 2020).…”

“…The potential of phytotherapeutic treatments was explored in 11 of the studies included in this review in relation to the application of phellodendron, quercetin, ichthammol glycerine, calendula, chamomile, sesame and aloe vera. A total of 8 studies reported an improvement in the phlebitis: calendula vs. application of warmth (Jourabloo et al, 2017), quercetin vs. eucerin (Ghorbani et al, 2016), phellodendron vs. magnesium sulphate (Wan, 2018) and ichthammol glycerine vs. heparinoids or magnesium sulphate‐glycerine (Basu et al, 2017; Thomas et al, 2016). In the study by Soloman et al (2015), ichthammol glycerine and heparinoids were found to be equally effective.…”

“…On the one hand, the use of a bandage does not impede evaporation of the product nor does it improve its effectiveness (Lian et al, 2017), while on the other occlusion of the area increases the absorption of the product (Sellarès Casas, 2013) and keeps the skin moist. In this review, use of a bandage (sterile or gauze dressing) together with the product was found to be effective in a total of 9 studies (Amuda et al, 2019; Bigdeli Shamloo et al, 2019; Ghorbani et al, 2016; Jayabharathi, 2015; Packialakshmi & Vidhya, 2017; Ravindra & Patel Krupa, 2015; Sharma, 2016; Thomas et al, 2016; Wan, 2018).…”

Hypoglycemic, hypolipidemic, and wound healing potential of quercetin in streptozotocin-induced diabetic rats

“…Ghorbani et al . [ 44 ] also reported that 2% quercetin cream was effective in treating phlebitis. Flavonoid helps in increasing collagen synthesis, promotes cross-linking of collagen, decreases the degradation of soluble collagen, promotes conversion of soluble collagen to insoluble collagen, and hinders the catabolism of soluble collagen.…”