ragged edge not fixed to the underlying tissues, it is fairly deep, is covered with a dirty looking necrotic slough or scab, and though not painful it is tender. The surrounding skin gets discoloured, infiltrated, inflamed and markedly cedematous, there is some lymphangitis and sometimes phlebitis. There may be a general malaise and slight evening rise of temperature owing to secondary infection.

This randomized, controlled trial involving 316 patients in the home setting found no difference in the rate of phlebitis and/or occlusion among patients for whom a peripheral intravenous catheter was routinely resited at 72-96 hours and those for whom it was replaced only on clinical indication (76.8 events per 1,000 device-days vs 87.3 events per 1,000 device-days; P = .71). There were no blo...

P a t i e n t s 293 patients who were receiving their first central venous catheterization during the index ICU stay. Exclusion criteria included a moribund state, emergency catheterization, coagulopathy, severe hypoxemia, skin lesions or recent surgery at either site, and phlebitis. Catheterization was attempted in 289 patients (mean age 61 y, 66% men). 99%, 92%, and 76% of patients were evalu...

Results Small interlobular veins were composed of endothelium and basement membrane, similar to capillaries, while the walls of large interlobular and arcuate veins had smooth muscle cell bundles forming the medial layer, similar to large extrarenal veins. In the control group, only focal mononuclear infiltration around small interlobular veins was found (8/31). In rejected kidney allografts, t...