Improving Jugular CVC Dressing Integrity: Findings from the STICKY Trial

Central venous catheters (CVCs) are essential in critical care, but their failure due to dressing disruption is a persistent issue—especially for jugular lines. The STICKY trial, a multicenter randomized controlled trial, examined whether adding a medical liquid adhesive (MLA) could improve dressing integrity for jugular CVCs in ICU patients.

Study Overview
This trial involved 160 adult ICU patients with jugular CVCs across four Australian hospitals. Patients were randomized to standard dressings with or without the addition of MLA (Mastisol) applied under the dressing border. The primary outcome was dressing failure due to lifting edges within 7 days. Secondary outcomes included dressing changes, skin injury, CVC failure, and cost-effectiveness.

Key Findings

• Dressing failure occurred in 28% of the MLA group versus 50% in the standard group, a significant reduction (OR 0.39; p = 0.005).
• MLA use extended median dressing dwell time from 24 hours (control) to 58.5 hours.
• Dressing changes were fewer in the MLA group (IRR 0.74).
• Skin injuries were rare: 1 in the MLA group (blister) and 2 in the control group (maceration, tear).
• No CLABSIs occurred, but local site infections were reported in two MLA cases.
• MLA resulted in cost savings of $11 per participant compared to standard care.

Conclusion
The STICKY trial shows that MLA significantly reduces dressing failure for jugular CVCs without increasing adverse skin events, offering a practical solution to improve CVC securement in ICU settings. The study recommends further research to assess whether MLA use reduces infection rates or overall CVC failure.

Read More:https://journals.lww.com/ccmjournal/fulltext/2025/02000/securing_jugular_central_venous_catheters_with.3.aspx 

Authors: Nicole Marsh, Catherine O’Brien, Emily N. Larsen, Evan Alexandrou, Robert S. Ware, India Pearse, Fiona Coyer, Maharshi S. Patel, Ruth H. Royle, Claire M. Rickard, Kellie Sosnowski, Patrick N. A. Harris, Kevin B. Laupland, Michelle J. Bauer, John F. Fraser, Craig McManus, Joshua Byrnes, Amanda Corley