Tissue Adhesive for Paediatric Vascular Access: What Works, What Doesn’t

Study Overview

In children, vascular access devices fail often—especially due to movement, dressing disruption, and dislodgement. Tissue adhesive (medical “skin glue”) is increasingly used to secure lines because it may reduce micromotion, act as a barrier at the insertion site, and help with small leaks or bleeding.

This systematic review and meta-analysis pulled together randomised trials in paediatric patients (post-neonatal discharge to <18 years) to test whether tissue adhesive (TA) improves outcomes for peripheral IV catheters (PIVCs) and central venous access devices (CVADs).

Five studies (1030 children) were included: 2 PIVC trials and 3 CVAD trials, all from Australia.

Key Findings

- For PIVCs: tissue adhesive reduced failure and complications
Across the two PIVC studies, TA was linked with fewer overall complications and fewer dislodgements, and it likely reduces failure—but certainty is limited because studies were small and results varied.

- Dislodgement dropped noticeably for PIVCs
One of the clearest signals was fewer complete dislodgements when TA was used to help secure peripheral lines.

- For CVADs: no clear benefit
Across CVAD studies, TA did not reduce device failure or complications.

- Skin injury was not increased in paediatric studies
Importantly, there was no clear signal that TA caused more skin injury in the included paediatric trials.

- Acceptability is mixed, especially around removal
Staff satisfaction was lower in some CVAD studies, particularly related to removal—suggesting training, technique, and familiarity matter.

Implications

This review points to a practical, device-specific message: tissue adhesive may be worth considering for paediatric PIVCs—especially where dislodgement and frequent complications are common—but it shouldn’t be assumed to help for CVAD securement.

The bigger takeaway is that securement needs to be catheter-specific. What helps a short peripheral line may not translate to central lines, where forces, dressings, and securement systems are different. Future trials need standardised protocols, clearer outcome reporting, and enough sample size to confirm which children and which device types benefit most.

Read More:https://www.sciencedirect.com/science/article/pii/S0965206X26000124?via%3Dihub 

Authors: Sabrina de Souza; Mari Takashima; Elouise Comber; Tricia M. Kleidon; Nicole Marsh; Deanne August; Amanda J. Ullman; Patricia Kuerten Rocha