Comparison of two blunt dissection sheath insertion techniques in peripherally inserted central catheter placement: a randomized non-inferiority trial

The study compared two sheath insertion techniques for peripherally inserted central catheter (PICC) placement in 500 adult patients. Patients were randomly divided into a one-step technique group (250 patients) and a two-step technique group (250 patients). First-attempt sheath insertion success was 92.0% in the one-step group and 95.6% in the two-step group. The one-step technique did not demonstrate non-inferiority compared to the conventional two-step technique. However, the one-step technique resulted in less severe puncture-site bleeding during the procedure. Insertion-site infection occurred in 0.4% of patients in each group, and phlebitis occurred in 1.2% and 0.8% of patients in the one-step and two-step groups, respectively. The findings do not support routine replacement of the two-step technique.