Long-term indwelling silastic central venous catheters: clinical audit leading to improved surgical technique.

A retrospective audit of the surgical insertion and clinical outcome of silastic venous catheters on our Haematology Unit was performed for the period 1985 to 1988. Twenty-three (58%) of the 40 lines had complications, and analysis showed that many were due to problems related to the surgical technique used. This altered our clinical practice, and over a 12 month period (January 1989 to January 1990) 26 central venous catheters have been placed in 24 patients by a dedicated surgical team using a standardized, altered technique. This has been to place all catheters via the right internal jugular vein and to confirm line position by on-table radiographic screening. A significant improvement in results is presented.