The midline catheter is a viable choice in patients with difficult vascular access due to extensive postburn scar contractures” Yokota et al (2019).
RATIONALE: Obtaining venous access in a patient with extensive postburn scar contractures is a challenge.
PATIENT CONCERNS: A 39-year-old woman suffered a burn 2 years previously with a total body surface area burn of 93%, and a burn index of 85. Reconstructive surgery was previously performed 39 times. Split-thickness skin grafting to the neck was planned. She had no accessible peripheral veins.
DIAGNOSIS: Difficult venous access due to excessive burn scar contractures.
INTERVENTIONS: Central venous catheterization was considered impossible even with ultrasound guidance. We placed a midline catheter for intraoperative venous access in a patient with extensive burn scar contractures. The midline catheter is a peripheral venous catheter placed in an arm vein.
OUTCOMES: We successfully placed a midline catheter in the right brachial vein. This catheter was used for 24 days without difficulty.
LESSONS: The midline catheter is a viable choice in patients with difficult vascular access due to extensive postburn scar contractures.
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Yokota, T., Tokumine, J., Lefor, A.K., Hasegawa, A., Yorozu, T. and Asao, T. (2019) Ultrasound-guided placement of a midline catheter in a patient with extensive postburn contractures: A Case report. Medicine. 98(3), p.e14208.