Consider: What is the difference between a vascular access round-tube in a vein to infuse life-saving medications or a drainage round-tube to relieve the body of excess life-ending fluids? Both round tubes need to be secured to accomplish the therapeutic goal.
Drains in the body vary in style, location, size, and duration of purpose. Sometimes short-term after a surgical procedure such that if they “fail” it is considered “normal” or “acceptable”. Nephro-related drains (NRD), biliary, or abscess drains depend on the precise location and the duration can be weeks or months!
An NRD may be a nephrostomy catheter or a nephroureterostomy catheter. The difference is where the internal tip of each tube is precisely located although the exit sites are identical and are replaced every 90-120 days.
A biliary drain has a small target area and may be in place for days to months. A drain for an abscess will remain in place until the problem is managed. The tip may become ineffective in the case of a large abscess, because the drain is doing its job and the abscess is shrinking. It is also likely that the tip has retracted out of the critical area and can no longer allow the infectious matter to exit. While NRDs and biliary drains have consistent exit areas, abscess drains may be placed anywhere in the body. It is reported that 15%- 26% of biliary, abscess, and NRDs fail before the scheduled removal date.1,2 These drain failures increase cost, risk, and procedure fatigue for the patients.
Because people move and ineffective securement fails. Most drains are secured with a variety of non-absorbable suture materials and creative knots. Sutures have always been an improvised and off-label device used to secure external catheters when no other options are available.3 This is only true in 2023 for drains larger than 12fr.
SecurAcath® is an engineered option to secure drains that is safer and more effective.4 Unfortunately, tradition, familiarity, and comfort seem to be the de facto reason clinicians attempt to secure drains with sutures today.
Consider their life on the other side of the tube; the patient or family will observe that the device is no longer draining, then check the external segment for kinks or twists, then flush to remove a potential blockage while worrying if they are doing it right. Only to discover that the “securement” has failed. Now comes their fear of what will happen while the drain is non-functional, how quickly it can be fixed, will it hurt, and how much it will cost? All this stress on top of their original health issue, simply because the securement was inadequate to allow activities of daily living.
SecurAcath is a subcutaneous anchor that secures the external segment of any round tube from 3fr – 12fr, without the risk of needlestick injury or additional punctures in the patient’s skin.4 Sutures are not an engineered securement device, and a 26% failure rate shows sutures are also ineffective.
With this information, why do clinicians continue to use an unsafe and ineffective method to secure lifesaving drains? The best-case scenario is they are unaware of SecurAcath as a drain securement option. The worst case would be they have always used sutures, not interested in change, and are resigned to the fact that drain dislodgement is just part of life. Some have a part of both scenarios driving their choice in securement.
In a study by Panach-Navarrete (2020) the possible risk factors for nephrostomy tube dislodgement were assessed.2 The researchers found that the newer the resident physician, the more likely the drain was to dislodge because “their suturing technique was not as well developed”. The overall rate of dislodgement was still 26% showing that no matter the experience of the clinician sutures were still ineffective for fixation of a drain.
Below is a video showing how easy and consistent the placement of SecurAcath is for a drain. Consider that there is no variation in the technique, knots, or suture material to create other assumptions for the drain to dislodge.
SecurAcath for drains is effective, safe, and stays with the drain for the duration of need.5 Unlike sutures, there are no additional injuries to the skin with initial placement or repeated replacements. Sutures lose tensile-strength over time and by the manufacturer’s Instructions for Use (IFU) should be removed after 10-14 days.6 SecurAcath has a consistent and unchanging grip on the drain no matter the duration of need, the activities of daily living, or the clinician’s experience level.
Eloquest Healthcare is committed to providing solutions that can help improve catheter securement and decrease complications while reducing unnecessary costs. For more information about SecurAcath, please call 1‐877‐433‐7626 or complete this form.
- Huang SY, Engstrom BI, Lungren MP, Kim CY. Management of Dysfunctional Catheters and Tubes Inserted by Interventional Radiology. Seminars in Interventional Radiology. 2015;32(2):67-77. doi:10.1055/s-0035-1549371
- Panach-Navarrete J, Tonazzi-Zorrilla R, Martínez-Jabaloyas JM. Dislodgement in Long-Term Patients with Nephrostomy Tube: Risk Factors and Comparative Analysis between Two Catheter Designs. Journal of Endourology. 2020;34(2):227-232. doi:10.1089/end.2019.0655
- Hawes, ML. Inconvenient: A look at the guidance for sutures in CVAD kits. Journal for the Association for Vascular Access. 2022;28(2):6-7. Doi:.org/JAVA-2023-28-2-08
- SecurAcath website: https://securacath.com/
- Symington, K, Hawes ML. Securing drains with a subcutaneous anchor: A case report [White paper].
- Ethicon wound closure manual. (2022). Johnson & Johnson, Inc. https://www.jnjmedtech.com/system/files/pdf/115681-220127_ETH_WC_WC%20Catalog_2022%20Update_12_22_0057_CA.pdf