Simple securing suture for the fixation of long-term central venous catheters with a Dacron cuff

We describe a simple securing suture designed to prevent the accidental dislodgement of long-term, Dacron-cuffed tunneled central venous catheters during the interval before fibrous ingrowth fixes the cuff. A 3-0 nylon suture is placed at the exit site around the plastic shaft of the tunneler before the catheter is pulled through the subcutaneous tunnel; after the catheter is positioned and the Dacron cuff is seated cranial to the suture loop, the suture is tied around the catheter. The technique was applied in 207 consecutive patients (108 men, 99 women; mean age 42.4 years) over a 15-month period, with a 100% technical success rate, no procedure-related catheter injury, and no dislodgement on follow-up chest radiography at 1 to 2 weeks. The suture is performed before catheter insertion, requires no additional incision, and can be removed at the bedside, providing a safe and efficient adjunct for catheter fixation.