Securing a tunneled catheter that hangs from the chest or abdominal area can be challenging for the home TPN consumer.  There is a very high risk for contamination and subsequent catheter related blood stream infection when catheter tubing hangs near an ostomy, gastrostomy tube, or diaper.  Tubing that gets tangled in clothing or caught on various household furnishings can cause chronic pulling at the exit site with eventual irritation or infection.

Numerous different methods are available to secure a tunneled catheter.  A securing loop can be placed under a transparent dressing or taped into place.  Catheter securing devices are available with snaps or Velcro strips.  These have a sticky backing and should remain in place for about a week.  Sometimes the devices are rather large, but can be trimmed to fit a smaller frame.  Some consumers like to secure their catheter to the shoulder area and route the tubing down their back or arm.  This keeps the catheter totally away from ostomies and tubes.  For children and infants, there are a few cloth wrap-type devices that have been created by parents for their children.  For women, a bra works nicely for coiling and tucking tubing.  Men should avoid shaving chest hair and instead, trim the hair with scissors before applying tapes.

These are just a few ideas that are available to assist with catheter positioning.  Keeping the tubing as clean and isolated as possible, and away from fecal or gastric contamination greatly reduces the risk for catheter related blood stream infection.