Further benefits of cyanoacrylate glue for central venous catheterisation

We read with interest the letters on the use of cyanoacrylate glue as an alternative to suturing central venous catheters securely 1, 2. We have used glue for this purpose at our hospital for many years now, not just for securing devices, but more for reducing peri-catheter bleeding at the exit site, specifically for peripherally inserted central catheters (PICCs) 3. Bleeding occurs after 40% of PICC placements without reverse tapering at 1 h, and 15% at 25 h, and causes patients anxiety and logistical problems. Using glue, we have reduced this prevalence to 0% at 1 h and 24 h in 45 patients. Sealing the exit site of catheters with glue also reduces the risk of extra-luminal contamination, presumably by reducing bacterial translocation at the puncture site 4. Glue may also reduce the risk of catheter displacement when sutureless devices, which are currently recommended as the optimal method for securement, are used 5. We hypothesise that glue may reduce ‘in and out’ movement of the catheter at the exit site, reducing local damage to the endothelium of the vein, and so reducing the risk of intravenous thrombus formation. Convinced of the benefits and safety of cyanoacrylate glue, we have extended its use in our hospital for sealing the exit site of all central venous access devices, cuffed and non-cuffed tunneled catheters and totally implanted port reservoirs, and for closing the skin after the removal of these. We would be interested in hearing from researchers interested in studying the antibacterial and antithrombotic potential of cyanoacrylate glue during central venous catheter insertion and removal.