Securing a Pleurx Lung Catheter
A Pleurx lung catheter is secured in place primarily through a combination of a stay suture, specialized dressings/fixation devices, and proper insertion technique to prevent dislodgement. 1
Primary Securing Methods
Stay Suture Method
- A non-absorbable suture is used to close the chest drain incision around the edge of the catheter
- A stay suture is placed through the skin and then criss-crossed up the drain
- Important: Ensure the suture is not too tight as it can occlude a soft drain 1
Specialized Fixation Devices
- Special dressings and manufactured catheter stabilization devices are specifically designed to hold catheters in place
- These are preferred over traditional methods like stitches alone 1
- Manufactured catheter stabilization devices (like Statlock) are recommended whenever feasible 1
Additional Securing Techniques
- Steristrips may be used to further stabilize the catheter
- A transparent adhesive dressing is often applied to allow inspection of the drain site while providing additional security 1
- An "omental tag" of tape can be used to allow the tube to lie slightly away from the chest wall, preventing tube kinking and reducing tension at the insertion site 1
Important Considerations
Avoiding Common Pitfalls
- Avoid using large amounts of tape and padding as they can restrict chest wall movement and increase moisture collection 1
- Avoid using scissors when changing dressings to prevent accidental damage to the catheter 1
- Never use stitches as the only securing method as they increase risk of:
- Local thrombosis/phlebitis
- Catheter-related bloodstream infections
- Dislocation
- Local infection at the exit site 1
Catheter Placement Factors
- Proper initial placement is crucial for preventing dislodgement
- For tunneled catheters, the cuff should be placed at least 2.5 cm inside the tunnel (or according to manufacturer's instructions) 1
- Appropriate catheter stabilization plays a major role in reducing local complications at the exit site 1
Long-term Management
- Regular assessment of the catheter site is essential
- Pleurx catheters can remain in place for extended periods (1-15 months) for intermittent drainage 2
- The complication rate for dislodgement with properly secured Pleurx catheters is relatively low (approximately 1.2%) 3
By following these guidelines for securing a Pleurx catheter, the risk of dislodgement can be minimized while maintaining patient comfort and catheter function for effective management of pleural effusions.