UC Irvine

Objective

To determine whether the wire-guided scalpel (GuideBlade) improves incision precision, reduces the need to revise dermatotomy incision, improves the first-time success rate of a central venous catheter (CVC) placement, and decreases CVC-related complications.

Design

A randomized 2-arm observational trial.

Setting

At University of California Irvine Medical Center.

Participants

Patients (n = 63) undergoing surgery requiring placement of a CVC as part of the standard of care recruited from August 1, 2021, to December 31, 2021.

Interventions

After randomization, either the GuideBlade (intervention) or the standard #11 scalpel (control) was used during CVC placement before surgery.

Measurements and main results

The number of dermatotomy attempts was higher using the GuideBlade (1.6 ± 1.0) compared to the standard #11 scalpel (1.4 ± 0.6); however, the difference did not reach statistical significance (p = 0.19). Similarly, the number of dilation attempts demonstrated no significant difference between the GuideBlade (1.2 ± 0.4) and the standard scalpel (1.1 ± 0.4; p = 0.65). No CVC-related infections or complications were documented.

Conclusions

No superiority was observed with using the GuideBlade compared to the standard scalpel during central line insertion by novice users. User unfamiliarity and inadequate training may have contributed to this finding, highlighting the importance of proper technique and user experience.