Introduction to SecurePortIV

This course introduces you to cyanoacrylate tissue adhesives and SecurePortIV.

Introducing Cyanoacrylates

Cyanoacrylates (CA’s) are a family of  adhesives more commonly known of as superglue. They cure rapidly and are very strong.  The process of an adhesive changing from liquid to a solid state is known as curing, as the chemical reaction takes place to form tough bonds within the formula.

The early products cured so fast they produced heat (this is called an exothermic reaction) and were somewhat toxic as when applied to skin they caused burns and allergic reactions.

Traditional medical TA’s are from the n-butyl family, they cure rapidly and are hard and brittle.

Clinicians use these medical grade CA’s as a Tissue Adhesive (TA) to approximate wound edges without the need for sutures.

Keen to tick all of the boxes of good VAD management, Vascular Access Specialists have in recent years combined a securement device with the use of a TA to rapidly seal the puncture site and prevent oozing/bleeding.

CA’s have evolved with the introduction of 2 Octyl-CA, which  has many benefits over the older formulations.  It cures somewhat slower than the original formulations but this allows the product to bond flexibly, becoming like a second skin.  This flexibility increases patient comfort and prevents damage to indwelling catheters.  The slower curing also decreases the toxicity of the product and produces no significant levels of heat during the process making it suitable for sensitive skin types.

TA’s are now recommended by the INS 2021¹ as an adjunct to good VA management and research into the benefits of TA’s cite multiple benefits.

Aims of good Vascular Access Devices (VAD) management:

• Protect the integrity of skin
• Protect the puncture site from skin organisms
• Reduce VAD movement and dislodgment
• Reduce unplanned dressing changes

Current methods of VAD management include; Sutures, Adhesive Engineered Stabilisation Devices (AESD’s) or Subcutaneously Anchored Securement Systems SASS’s .  Whilst these methods of securement have their advantages they do not provide a complete solution.

Introducing SecurePortIV

SecurePortIV (SPIV) is the first and only CA licensed for use with VA catheters.  It is a 2 Octyl CA which cures slower and more flexibly than traditional medical grade TA’s and has been rigorously tested for compatibility with catheters.

Adhesive securement devices and sutures allow catheters to move within the insertion site which may lead to phlebitis or migration of the line.  SPIV secures directly at the catheter skin junction, reducing catheter movement, pistoning, migration and dislodgment.

Inserting a  vascular access catheter creates a puncture in the patients skin which may ooze or bleed.  Applying SPIV seals the insertion site creating a haemostatic barrier that prevents further oozing.  This may eliminate the need for a pressure dressing and 24 hours dressing change.

The CA formulation in SPIV is effective against gram-negative and gram-positive bacteria, yeast and fungi, eliminating greater than 8-logs after 3 minutes in-vitro studies².

• SPIV is transparent and allows direct visualisation of the insertion site at all times.
• Can be used on any percutaneous catheter
• Is safe for use in neonates and patients sensitive to chlorhexidine

• Requires minimal surface area beyond the catheter footprint for securement making it adaptable for any anatomical location and tiny patients such as preterm babies.

Where can SPIV be used:

• Peripheral IV catheters (PIV’s)
• Midlines
• Peripherally & Centrally Inserted Central Catheters (PICC’s & CICC’s)
• Peripheral arterial catheters (A lines)
• Epidural catheters
• Neonates (including Preterm’s)

Click the link below to see benefits of SPIV in action

References

1. Gorski, L. A., Hadaway, L., Hagle, M. E., Broadhurst, D., Clare, S., Kleidon, T., . . . Alexander, M. (2021). Infusion Therapy Standards of Practice, 8th Edition. J Infus Nurs, 44(1S Suppl 1), S1-S224. doi:10.1097/NAN.0000000000000396
2. Prince et al. Immobilization and Death of Bacteria by Flora Seal® Microbial Sealant. International Journal of Pharmaceutical Science Invention, Jun 2017