Silicone Foley catheters outperform latex Foley catheters for post-nasal packing: an in-vitro study.

摘要

Objectives: To determine the best Foley catheter and inflation fluid for post-nasal packing. Design: Experimental study. Setting: District General Hospital (Wexham Park Hospital). Materials: 108 latex and 108 silicone catheters were directly compared. Outcome measures: Catheters were analysed according to the inflation fluid instilled and the use of an umbilical clamp. Analysis occurred at 24, 36, 48 and 72 h periods after being placed in humidified incubator at 37 degrees C. The main outcome measure was whether deflation was possible at specified times. The secondary outcome measure was an attempt to identify the failure point in those catheters that failed to deflate. Results: Air was found to be an unsuitable inflation fluid for either silicone or latex catheters due to a 100% spontaneous deflation rate within a 24-h period. Silicone catheters were found to be 100% reliable when inflated with water or saline, irrespective of the use of a clamp. Latex catheters were unreliable with an overall failurerate of 30%. This high failure rate was related both to the use of an umbilical clamp to secure the catheter and to the use of saline as the inflation medium. Conclusions and recommendations: Firstly, air should not be used for inflation of catheters unless specified in manufacturer's instructions. Secondly, when Foley catheters are used for post-nasal packing, silicone should be considered the first choice of catheter type. If not available, latex ones may be used but should be inflated with water and secured with a non-crushing clamp at the alar rim.