Hello 99ers,

A little belated but Happy New Year to everyone.

I work in a tertiary centre in the UK and have been approached in regard to adopting the use of cyanoacrylate glue for line fixation.

Would be extremely grateful for your thoughts, opinions and experiences on its use. I am not sensing a wide ‘buy in’ in the UK currently and would like to unpick any themes.

Grateful for your time.

Warmest wishes

Al

I would say that this is @Roland NNP s expert field!

Do you have any comments? 😊

Dear Ali,

Thank you for raising this — it’s a very relevant topic.

Cyanoacrylate tissue adhesive for catheter securement has been increasingly studied over the past years. The potential advantages include not only improved catheter stabilization, reduced micromotion at the insertion site, decreased early dislodgement, and a possible reduction in bleeding but also microbial ingress at the exit site. However careful product selection and application technique are essential. It is also important to distinguish between wound-closure adhesives and medical-grade catheter securement glues, as they are not interchangeable in terms of formulation, flexibility, and regulatory approval.

Recent international vascular access guidelines, including the Infusion Nurses Society (INS) Standards of Practice, recognise medical-grade tissue adhesive as part of a securement and stabilisation bundle for vascular access devices. While UK uptake has perhaps been slower and varies between centres, the direction of use internationally is toward viewing cyanoacrylate as an adjunct to improve stabilisation rather than as a standalone solution. In neonatal practice specifically, the published evidence to date has not demonstrated increased harm or medical adhesive-related skin injury (MARSI) when appropriate products and techniques are used (for application and removal), although continued evaluation and careful implementation remain important.

Cyanoacrylate glue of catheter securement is available within the NHS and used in many NICU's in the UK. In my experience, uptake often depends less on the adhesive itself and more on local culture, training, and clarity about indications. Themes I’ve seen influencing “buy-in” include concerns about skin integrity (especially in neonates), unfamiliarity with application technique, uncertainty around removal practices, and the perception that current securement methods are “good enough.” Where implementation has been successful, it has usually involved clear protocols, defined indications, staff education, and outcome monitoring rather than blanket adoption.

Happy to discuss further if helpful.

Regards, Roland

A few references:

Piersigilli, F., Iacona, G., Yazami, S. et al. Cyanoacrylate glue as part of a new bundle to decrease neonatal PICC-related complications. Eur J Pediatr 182, 5607–5613 (2023). https://doi.org/10.1007/s00431-023-05253-0

Barone G, Piersigilli F, Pittiruti M. Vascular access in the newborn: a position paper of Neonatal European Vascular Access Teams (NEVAT). Eur J Pediatr. 2026;185(2):71. Published 2026 Jan 12. doi:10.1007/s00431-025-06717-1

D’Andrea V et al (2022) Use of cyanoacrylate glue for the sutureless securement of PICC's (epicutaneo-caval catheters) in neonates. J Vasc Access 23(5):801–804 - DOI - PubMed

D’Andrea V et al (2023) Securement of umbilical venous catheter using cyanoacrylate glue: a randomized controlled trial. J Pediatr 260:113517 - DOI - PubMed

van Rens M et al (2022) Cyanoacrylate securement in neonatal PICC use: a 4-year observational study. Adv Neonatal Care 22(3):270–279 - DOI - PubMed

van Rens MF et al (2023) Octyl-butyl-cyanoacrylate glue for securement of peripheral intravenous catheters: a retrospective, observational study in the neonatal population. J Vasc Access 25(4):1229–1237. 10.1177/11297298231154629 - PMC - PubMed

Thank you Roland for such a clear overview of the approach and application. I will take this to the medical governance team for further discussion.

Thank you once again.

Al 👍

Thanks @Roland NNP . It would be interesting to know which units are using it, @ali and what their data looks like for CLABSI rates.......

Happy to share the units but perhaps better from a privacy point of view not in an online post? What do you think?

Oh no, sorry, I did not mean to share private information! Please do not do this! ;-)

I just wondered if there was a UK survey, for example, that might @ali in reviewing current practice!

There will be a topic on cyanoacrylate in your new BAMP guidelines.