Isobutyl α-cyanoacrylate glue for managing persistent exudate at the PICC puncture site: a retrospective cohort study

To evaluate the effectiveness of α-cyanoacrylate glue in managing persistent exudate at the puncture site following peripherally inserted central catheter (PICC) placement. A retrospective analysis was conducted on patients who underwent PICC placement at our hospital's PICC treatment center from January 2020 to December 2024. Patients with persistent exudate were identified, and logistic regression analysis was performed to determine risk factors associated with exudate. Patients were divided into two groups: one treated with α-cyanoacrylate glue and the other with conventional gauze compression. Cases with multiple unfavorable factors for healing were excluded. The recurrence rate of exudate, infection rate, catheter dislodgement rate, catheter injury rate, and the average number of dressing changes were compared between the two groups. Out of 3016 patients, 58 cases of persistent exudate were identified. Logistic regression analysis revealed that dermatographism, allergy history, hypoproteinemia, and interleukin elevation were independent risk factors for exudate. After excluding cases with multiple unfavorable factors, 57 patients were included in the analysis (30 in the α-cyanoacrylate glue group and 27 in the gauze compression group). The α-cyanoacrylate glue group showed significantly lower rates of exudate recurrence (P < 0.001), catheter dislodgement (P = 0.044), and catheter injury (P = 0.019), as well as fewer average dressing changes (P = 0.032). In the α-cyanoacrylate glue group, patients with an allergy history had a 100% healing rate (P = 0.033), those with hypoproteinemia had a 90.9% healing rate (P = 0.043), and those with dermatographism had a 90.0% healing rate (P = 0.012). However, patients with interleukin elevation had less favorable outcomes (P = 0.265). The use of α-cyanoacrylate glue for managing persistent exudate at the PICC puncture site significantly improves exudate control, reduces postoperative complications, and enhances nursing quality and patient safety. However, its effectiveness may be limited in patients with elevated interleukin levels, indicating a need for further research to identify more effective management strategies for this subgroup.