CONTAMINATION OF CENTRAL VENOUS CATHETERS - THE SKIN INSERTION WOUND IS A MAJOR SOURCE OF CONTAMINATION

In a prospective controlled trial we compared the rates of catheter-ti p contamination in central venous catheters inserted with or without s kin contact. The study was designed so that each patient was their own control. All patients had a single-lumen central venous catheter and a Swan-Gantz sheet inserted through the skin. A Swan-Gantz catheter wa s inserted and retracted through the sheet thus avoiding contact with skin or subcutaneous tissue. Catheter-tip cultures were performed on r emoval of catheters. Thirty-three Swan-Gantz catheters were cultured a nd all were sterile. In the corresponding 33 sheets 16 (48.6%) yielded bacterial growth. Four of the sheets showed growth of more than 15 cf u. In the 26 single-lumen catheters, eight (30.8%) catheter-tips grew bacteria, and four of them had more than 15 colonies. The study suppor ts the theory that the skin-insertion wound is a major source of cathe ter-contamination.