IV Drip Failure Reduced by Skin Glue Application

Using medical cyanoacrylate skin glue to hold intravenous (IV) drips in place significantly reduces the need to replace them, according to a new study.

Researchers at Caboolture Hospital (Australia), the University of Queensland (Brisbane, Australia), and other institutions conducted a randomized, controlled trial of 380 peripheral IV catheters inserted into 360 adult patients to examine if failure rates could be reduced by the addition of a cyanoacrylate skin glue to standard care. The primary outcome was peripheral IV catheter failure at 48 hours, regardless of cause, and secondary outcomes were rates of specific failure causes, including infection, phlebitis, occlusion, or dislodgement.

The results showed that peripheral IV catheter failure was 10% lower with skin glue (17%) than standard care (27%), and IV drip dislodgement was 7% lower. Phlebitis and occlusion were also lower with skin glue, but were not statistically significant, and there were no infections. Empirically, the researchers reported that they found that using medical-grade superglue made IV lines five times harder to pull out. The study was published in the August 2016 issue of Annals of Emergency Medicine.

“We found that by using medical skin glue, we could reduce the failure rate to below 17%. The glue made IV lines harder to unintentionally remove, and was also shown to kill the bacteria that most commonly cause infections,” said lead author Simon Bugden, MD, of the department of emergency medicine. “The other major benefit was patient comfort, with patients in the trial reporting that the glue caused less irritation and they were less worried about the lines falling out.”

“There has been no improvement to the current procedure of inserting and securing IV lines in several decades, despite the rate of failure,” commented Professor Sally McCarthy, of the Emergency Medicine Foundation of Australia (EMF; Brisbane, Australia), who helped fund the study. “Dr. Bugden's method could be simply and cost-effectively introduced in hospitals worldwide. EMF is committed to ensuring Australia continues to stay at the forefront of emergency medicine care by funding to dedicated research in this field.”

Cyanoacrylates are a family of strong fast-acting adhesives with industrial, medical, and household uses, and are known generically as instant glues or superglues. The acrylic resin base rapidly polymerizes in the presence of water, forming long, strong chains that join the bonded surfaces together. The medical versions are based on n-butyl cyanoacrylate and 2-octyl cyanoacrylate, which was specifically developed to address toxicity concerns and to reduce skin irritation and allergic response.

Related Links:
Caboolture Hospital
University of Queensland
Emergency Medicine Foundation of Australia