Vascular access device dressing optimisation using tissue adhesive.

Abstract

Background: The care and maintenance of vascular access devices (VADs) encompass all stages from assessment and insertion to ongoing care and removal. Post-insertion, dressings protect the site, aid in haemostasis and provide securement. However, catheter-related bloodstream infections (CRBSIs) may occur owing to pathogen migration or contamination during dressing changes. Traditional sterile gauze dressings, which require frequent changes, may offer inadequate protection. Tissue adhesives, specifically cyanoacrylate glue, have shown promise in enhancing haemostasis, securement and offering bacteriostatic properties.

Methodology: This study reviewed electronic patient records and databases for VADs inserted by the vascular access team using the modified Seldinger technique. The review focused on the use of tissue adhesive in adults and in some cases older children. The study compared traditional dressings with those enhanced by tissue adhesive, documenting haemostasis, securement and incidence of infection.

Results: The use of tissue adhesive improved haemostasis and securement, reducing the need for early dressing changes. The bacteriostatic properties of the adhesive decreased the rate of CRBSIs. Its use also preserved dressing integrity by controlling bleeding and exudation, potentially allowing dressings to remain intact for 7 days. Despite the initial expense, tissue adhesive use led to significant savings by reducing the frequency of dressing changes and associated nursing time.

Conclusion: Tissue adhesives optimise VAD dressing by enhancing haemostasis, securement and infection control. This practice improves patient outcomes and reduces costs. The findings support the integration of tissue adhesives into standard VAD care protocols to enhance patient safety and operational efficiency. In future, research may explore the use of tissue adhesives in larger bore VADs and other clinical applications.