Comparison of Uncoated vs. Transiently Coated Central Venous Catheters for the Prevention of Biofilm Formation in Cardiac Surgery Patients

All articles of this category (opens in new window) Background: Central venous catheters (CVCs) are essential in cardiac surgery but can become contaminated by bacteria from the patient’s skin, sometimes causing bloodstream infections and sepsis. Standard disinfectants may not reach bacteria in deeper skin layers. Biofilms develop on about 10% of catheters, even from a single bacterium, and can release large bacterial colonies into the bloodstream, leading to catheter-related bloodstream infections (CRBSI). Coating catheters with antibacterial gel may help reduce this risk and provide extra protection. Methods: As part of a multicenter, prospective, randomized study (CutSep, Solvamed), 195 patients undergoing cardiac surgery at our institute were randomly assigned to two groups: Group A (in situ gel-coated CVC, n: 92) and Group B (control group, n:103). In Group A, after triple skin disinfection, the CVC was coated with a gel containing 0.05% Octenidine using a device. Patients with preexisting infections, such as endocarditis, were excluded. All explanted CVCs were examined microbiologically. All patients received 1.5 g of Cefuroxim perioperative. Results: All patients underwent elective surgery, with a mean age of 70.4 years; 26% were female. The procedures included coronary artery bypass grafting in 61%, isolated valve surgery in 33%, and combined operations in 4%. The mean duration of CVC placement was 5.97 days in both groups. On the day of CVC removal, mean CRP levels were 79.2 mg/L in Group A and 79.7 mg/L in Group B. Positive catheter cultures were found in 6 patients (6.5%) in Group A and 11 patients (10.7%) in Group B, corresponding to a 38.9% lower incidence in Group A. All positive tips grew Staphylococcus species. Mean leukocyte count was 10.1 G/L in all groups. Among patients with positive catheter tips, CRP averaged 81.0 mg/L with antibiotic use in 33% (Group A) and 79.2 mg/L with 54% antibiotic use (Group B). In patients with negative catheter tips, CRP was 79.2 mg/L, and antibiotics were used in 54.5%. Conclusion: Using an antiseptic gel to coat central venous catheters in cardiac surgery patients reduced the number of positive catheter cultures by almost 40% compared with uncoated catheters. These findings suggest that antibacterial gel coating may provide an effective additional layer of protection against CRBSI in this high-risk population. Despite perioperative antibiotics and the use of Chlorhexidine dressing, CVC contamination remains common. In this study, this problem during CVC insertion was addressed for the first time with a new medical device. Publication History Article published online: 17 February 2026 © 2026. Thieme. All rights reserved. Georg Thieme Verlag KG Oswald-Hesse-Straße 50, 70469 Stuttgart, Germany