Title: Prevalence of Phlebitis and Comparison of the Effectiveness of Topical Ichthammol Glycerin and Heparinoid Application on Phlebitis among Patients on Peripheral Intravenous Therapy
Authors: Minnu Thomas, Dr Punitha Ezhilarasu, Mrs Jeyalindha Christopher
DOI: http://dx.doi.org/10.18535/jmscr/v4i8.96
Aim: The aim of this study was to determine the prevalence of phlebitis and compare the effectiveness of topical ichthammol glycerin and heparinoid application on phlebitis among patients receiving intravenous therapy. Background: The incidence of thrombophlebitis varies and various treatment modalities are available for treating phlebitis. Design: Quasi experimental design. Method: The study was conducted in the general medical, surgical and orthopaedic wards among 90 patients. Cluster randomization technique was used to allocate the wards to each interventional group. Consecutive sampling technique was used to select the subjects from each ward. Subjects were observed for 48 hours with an interval of 12 hours. Visual infusion phlebitis scale and numeric pain intensity scale were used to collect data. Results: The prevalence of phlebitis was 26.07% for the time period of six weeks from June 25,2012 to August 5,2012. Result showed that ichthammol glycerin was more effective than heparinoid application based on the observation at 12 hours and 24 hours after the introduction of the intervention(p=.001). Both interventions were found to be equally effective at 48 hours of the observation. Conclusion: This study demonstrated evidence on the more effective intervention (ichthammol glycerin) for the management of phlebitis. Trial registration: The study was registered in Clinical Trials Registry of India (CTRI/2012/05/002629). Keywords: phlebitis, incidence, risk factors, management, ichthammol glycerin, heparinoid application. 1. Nassaji-Zavareh M, Ghorbani R. Peripheral intravenous catheter-related phlebitis and related risk factors. Singapore Med J. 2007 Aug;48(8):733–6. 2. Smeltzer S&Bare B.,(2000), Brunner and Suddarth’s Textbook of Medical-Surgical Nursing. 9th ed. Philadelphia: Lippincott: 241-2. Brunner & Suddarth’s Textbook of Medical-Surgical Nursing, 9th Edition by Brunner: Suddarth: Lippincott Williams & Wilkins, Philadelphia, PA 9780781715751 Hardcover, 9th Edition - a2zbooks [Internet]. [cited 2016 Aug 17]. Available from: http://www.abebooks.com/Brunner-Suddarths-Textbook-Medical-Surgical-Nursing-9th/771942207/bd 3. Tagalakis V, Kahn SR, Libman M, Blostein M. The epidemiology of peripheral vein infusion thrombophlebitis: a critical review. Am J Med. 2002 Aug 1;113(2):146–51. 4. Perucca R, Micek J. Treatment of infusion-related phlebitis: review and nursing protocol. J Intraven Nurs. 1993 Oct;16(5):282–6. 5. White SA. Peripheral intravenous therapy-related phlebitis rates in an adult population. J Intraven Nurs. 2001 Feb;24(1):19–24. 6. Ahlqvist M. Peripheral venous catheters : Quality of care assessment [Internet]. Institutionen för klinisk vetenskap / Department of Clinical Sciences; 2009 [cited 2016 Aug 11]. Available from: http://openarchive.ki.se/xmlui/handle/10616/40208 7. Vilardell M, Sabat D, Arnaiz JA, Bleda MJ, Castel JM, Laporte JR, et al. Topical heparin for the treatment of acute superficial phlebitis secondary to indwelling intravenous catheter. A double-blind, randomized, placebo-controlled trial. Eur J Clin Pharmacol. 1999 Feb;54(12):917–21. 8. Vecchio C, Frisinghelli A. Topically applied heparins for the treatment of vascular disorders : a comprehensive review. Clin Drug Investig. 2008;28(10):603–14. 9. Saini B, Paul P. Effectiveness of cold application, heparinoid application and magnesium sulphate application on superficial thrombophlebitis among pateints. Ind J nsg 2011;2(1):4-10 10. Masood A, Moumoulidis I, Ray S, Chawla O, Panesar J. A randomised controlled trial comparing Triadcortyl with 10% glycerine-ichthammol in the initial treatment of severe acute otitis externa. Eur Arch Otorhinolaryngol. 2008 Aug;265(8):881–5. 11. Beulah, D. A comparative study on the efficacy of treatment with ichthammol glycerine and infrared radiation for thrombophlebitis in patients receiving intravenous administration of fluids through peripheral venipuncture in general surgical wards Christian Medical College Vellore. MSc.(dissertation), Chennai: Dr.M.G.R.Medical university, Chennai ; 1987 12. Grüne F, Schrappe M, Basten J, Wenchel HM, Tual E, Stützer H, et al. Phlebitis rate and time kinetics of short peripheral intravenous catheters. Infection. 2004 Feb;32(1):30–2. 13. Rego Furtado LC do. Incidence and predisposing factors of phlebitis in a surgery department. Br J Nurs. 2011 Aug 28;20(14):S16–8, S20, S22 passim 14. Ahmed K, Roberts ML, Mannion PT. Antimicrobial activity of glycerine-ichthammol in otitis externa. Clin Otolaryngol Allied Sci. 1995 Jun;20(3):201–3. 15. Wang L, Brown JR, Varki A, Esko JD. Heparin’s anti-inflammatory effects require glucosamine 6-O-sulfation and are mediated by blockade of L- and P-selectins. J Clin Invest. 2002 Jul 1;110(1):127–36Abstract
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