As we all know, PICC is a kind of catheterization technology that is introduced from the peripheral vein and ends in the superior vena cava. It has been widely used in clinical practice, especially for cancer chemotherapy patients. It can effectively reduce the extravasation of chemotherapy drugs, and at the same time, it can avoid repeated venipuncture to protect blood vessels and relieve patients' pain.

Although PICC has many advantages, it is found that catheter slippage, catheter migration and other related complications caused by improper fixation during use. In addition, with the movement of the limbs, the repeated movement of the catheter at the puncture site will stimulate the puncture site, leading to the formation of granuloma at the puncture site, which may induce local infection.

These complications not only increase the psychological pressure of patients, but also may lead to unexpected extubation in severe cases. How to properly fix the catheter and reduce the complications caused by improper fixation has also become a research hotspot in clinical nursing.

It is reported in the literature that the suture free catheter fixing device (Sukang D-D1 product) does not contain latex, and the fixing pad contains a layer of strong adhesive, which can be tightly bonded with the skin, firmly fixed, so that the catheter is not easy to move, and the catheter will not move when moving.

Using suture free catheter fixation device to fix PICC catheter for patients can reduce the occurrence of granuloma at puncture point, effectively reduce the rate of PICC catheter prolapse, make patients feel safe and comfortable, and improve the compliance of patients with catheter.

As for the replacement frequency, it is generally replaced together with the transparent coating during maintenance once a week.

However, in clinical practice, there are also some practical problems. For example, the suture free catheter fixing device used for the first time is an accessory in the original package of PICC catheter. When it is replaced again, some hospital equipment departments do not have a stock of suture free catheter fixing devices, and patients need to buy them at their own expense. Therefore, the suture free catheter fixing device is basically no longer used for catheter fixation during subsequent maintenance.

Case sharing
Next, the author discusses the replacement of suture free catheter fixation device in combination with clinical cases. Welcome to leave a message to participate in the discussion.
The patient in the following figure is the first day after PICC catheterization, and a small amount of old blood seepage can be seen at the puncture point:

Considering that the suture free catheter fixation device has been used for only one day, and the time of catheter insertion is less than one week, there is blood leakage at the puncture point, in order to avoid the stimulation of the puncture point caused by catheter movement, the suture free catheter fixation device will be retained for the first replacement.

After local skin disinfection, place alginate dressing at the puncture point, and apply transparent dressing 10cm externally × 10cm.

If there is no abnormality, the suture free catheter fixation device of the patient will be removed during the next maintenance.

Topic extension
If there is no suture free catheter fixation device to assist in fixing the catheter, patients with good compliance can avoid complications such as catheter displacement and slippage as long as we fix the catheter correctly and pay attention to protection.

As shown in the figure below, the left side is the patch replaced a week ago, and the right side is the patch just replaced. The patch and catheter are properly fixed.

Fixation and removal of suture free catheter fixing device
Let's first learn about the fixation method of suture free catheter fixation device:
1. Clean the puncture point and surrounding skin with iodophor and ethanol, and wait for drying;
2. Wipe the fixed part with skin protection agent and leave it completely dry for 10-15s;
3. Place the suture free catheter fixing device in the direction indicated by the arrow (the arrow should point to the puncture point), install the suture hole on the catheter fixing wing on its pillar, fix the device and catheter, and lock the lock catch.
4. Remove the adhesive backed paper of the suture free catheter fixing device in turn and stick it on the skin.
5. 10cm × The 12cm transparent dressing shall be pasted without tension, and the center of the transparent dressing shall be aligned with the puncture point. The suture free catheter fixing device shall be completely covered, and the air under the film shall be drained to integrate the skin, catheter and film;