To the Editor.—
After reading Dr Fisher's1 article, I am amazed that the author was able to remove any Hickman catheter by "gentle traction." With the Dacron cuff bonded to the catheter, it is our experience that it is firmly adherent and would take much more than gentle traction to remove this. In fact, it would take tearing away this cuff from the surrounding tissue to which it was bonded by fibrous ingrowth. In our experience, we remove these in the office, placing a small amount of local anesthesia over the cuff, making a small incision, dissecting around the cuff, and easily removing the cuff and entire catheter. One stitch is needed to close the small skin opening. We have had no infectious complications from this procedure, and this virtually eliminates the complication of a retained foreign body.
Powell TH. The Removal of Central Venous Silicone Rubber Catheters. JAMA. 1986;255(15):2022. doi:10.1001/jama.1986.03370150063011