A method to prevent unintentional removal of a Hickman catheter

Many patients benefit from the use of tunneled Dacron-cuffed central venous catheters. Operative insertion with the aid of fluoroscopy is required for the proper placement of these devices. Perioperative unintentional removal of the catheter is a reported complication. The outward migration of the device occurs before adequate tissue ingrowth into the Dacron cuff has taken place. The frequency with which this unfavorable outcome occurs can be reduced by placement of a subcutaneous absorbable restraining suture distal to the Dacron cuff during the insertion procedure. The authors advocate the routine use of this adjunctive measure for the insertion of all Dacron-cuffed caval catheters.