Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2024 Jul 26;3(1):281-285.
doi: 10.1016/j.atssr.2024.07.009. eCollection 2025 Mar.

The Catheter Fell Out

Peyton Mashni  1 , Clare Savage  2 , Michael Jax  3 , Anna Maria Reiter  4 , Gordon Butler  2 , Joseph B Zwischenberger  3
Affiliations

The Catheter Fell Out

Peyton Mashni et al. Ann Thorac Surg Short Rep. .

Abstract

Background: Accidental catheter removal or drain dislodgment, including tube thoracostomy, is a common, high-risk complication in hospitalized and ambulatory patients that often necessitates an additional procedure, increased length of stay, and increased cost.

Methods: The aim of this study was to compare the tensile strength of pigtail catheter fixation using a simple interrupted suture, a U-stitch suture, or 2 simple interrupted skin sutures in a standardized skin model. Catheters were sutured to the skin, penetrating the collagen layer, with 1 of the 3 suture techniques and varying suture combinations.

Results: For each trial, breakage occurred at the suture or knot. The mean breakpoint varied significantly between 2 simple interrupted sutures and both the 1 simple interrupted suture and the U-stitch technique (analysis of variance post hoc test P < .001), with the 2 simple interrupted suture technique withholding nearly 40% more force. Using the strongest suture, 0 silk, on a deceased adult sheep to secure a pigtail thoracostomy catheter yielded identical data compared with the standardized skin model.

Conclusions: In conclusion, 2 simple interrupted skin sutures to secure a pigtail catheter has very low risk with a strongly positive benefit.

PubMed Disclaimer

Figures

Figure 1
Figure 1
(A-I) Step-by-step illustration of the suture technique and force measurement setup.
Figure 2
Figure 2
Mean breakpoint strength and SD in kilograms for 0 and 2-0 silk. Breakpoint varies significantly between the 2 simple interrupted sutures technique and the 1 simple or U-stitch technique (P < .001).
Figure 3
Figure 3
Mean breakpoint strength and SD in kilograms for the 1 simple interrupted suture technique and the 2 simple interrupted sutures technique in both the standardized skin model and sheep skin.
See this image and copyright information in PMC

References

    1. Carrión M.I., Ayuso D., Marcos M., et al. Accidental removal of endotracheal and nasogastric tubes and intravascular catheters. Crit Care Med. 2000;28:63–66. doi: 10.1097/00003246-200001000-00010. - DOI - PubMed
    1. Lorente L., Huidobro M.S., Martín M.M., Jiménez A., Mora M.L. Accidental catheter removal in critically ill patients: a prospective and observational study. Crit Care. 2004;8:R229–R233. doi: 10.1186/cc2874. - DOI - PMC - PubMed
    1. Galazzi A., Adamini I., Consonni D., et al. Accidental removal of devices in intensive care unit: an eight-year observational study. Intensive Crit Care Nurs. 2019;54:34–38. doi: 10.1016/j.iccn.2019.06.002. - DOI - PubMed
    1. Kato M., Fauziah W., Yamashita T., et al. Prevalence and prevention of unplanned removal of tubes and catheters among hospitalized patients. Int J Caring Sci. 2021;14:385–391. https://search.ebscohost.com/login.aspx?direct=true&AuthType=shib&db=ccm...
    1. Bohula E.A., Katz J.N., van Diepen S., et al. Demographics, care patterns, and outcomes of patients admitted to cardiac intensive care units: the Critical Care Cardiology Trials Network Prospective North American Multicenter Registry of Cardiac Critical Illness. JAMA Cardiol. 2019;4:928–935. doi: 10.1001/jamacardio.2019.2467. - DOI - PMC - PubMed

LinkOut - more resources