Abstract:
Objective: To test the effectiveness of a novel wire-guided scalpel (Guideblade) to create a precise dermatotomy incision for central venous catheter (CVC) insertion.
Design: Prospective, nonrandomized interventional study.
Setting: Stanford University, single-center teaching hospital.
Participants: Cardiac and vascular surgical patients (n = 100) with planned CVC insertion for operation.
Interventions: A wire-guided scalpel was used during CVC insertion.
Results: A total of 188 CVCs were performed successfully with a wire-guided scalpel without the need for additional equipment in 100 patients, and 94% of CVCs were accomplished with only a single dermatotomy attempt. “No bleeding” or “minimal bleeding” at the insertion site was observed in 90% of patients 30 minutes after insertion and 80.7% at the conclusion of surgery.
Conclusion: The wire-guided scalpel was effective in performing dermatotomy for CVC with a 100% success rate and a very high first-attempt rate. The wire-guided scalpel may decrease bleeding at the CVC insertion site.
Reference:Keeyapaj W, Cheung AT. Evaluation of the Efficacy of a Novel Dermatotomy Device for Central Venous Cannulation. J Cardiothorac Vasc Anesth. 2024 May 6:S1053-0770(24)00239-8. doi: 10.1053/j.jvca.2024.04.003. Epub ahead of print. PMID: 38908939.