gms | German Medical Science

Introduction: Acute phlebitis due to peripheral vein catheters remains a frequent disease in clinical practice with prolonged hospital stay, increased morbidity, mortality and healthcare costs. This retrospective study was designed to increase awareness, value current treatment options and suggest recommendations to reduce incidences and optimize treatment outcomes.

Material and methods: A total of 240 patients with the diagnosis of phlebitis, presented to our department between 2006 and 2011, were retrospectively studied. Initial clinical features, parameters, grading of severity (Baxter Scale), treatment regimes and follow up results were evaluated. Results are presented after division into 2 subgroups: conservative (n=132) versus operative treatment (n=108).

Results: Surgical intervention rates according to the location were higher in the cubital fossa (p= 0.06) compared to the forearm (p=0.21) and hand region (p=0.25). Baxter Scales were higher in the surgical treatment group (4.47) as compared to conservative treatment (2.67). Microbiology testing revealed Staphylococcus in 68.2% of all affected puncture sites. Surgically treated patients had a prolonged mean hospital stay of 8 days (29.7 versus 21.7 days).

Conclusion: Phlebitis with the signs of Baxter Scale Grade 4 or 5 should be considered for early surgical intervention, while phlebitis Grade 1 to 3 responds well to conservative measures. Additional criteria like age, comorbidities or inflammatory parameters have no considerably strong impact concerning the decision of a surgical treatment. However, usage and location of peripheral vein catheters need to be judged critically in each individual patient. Early involvement of surgical disciplines might be of certain advantage.