Change of central venous catheter dressings twice a week is superior to once a week in patients with haematological malignancies.
Thirty-two consecutive patients with haematological disorders, in need of a permanent central venous catheter (CVC) were randomly allocated to have their CVC bandages (Tegaderm) changed once (OAW, n = 20) or twice (TAW, n = 19) a week. The two randomization arms were balanced in respect of age, sex, and underlying disease. The exit site of the CVC was inspected daily through the transparent bandage and erythema was noted. If severe erythema occurred, daily wet gauze dressings were applied. Samples for bacterial cultures were taken from the exit site of the CVC at every change of bandages. There was no difference in complications leading to removal of the CVC between the two groups (7/20 OAW vs. 7/19 TAW) or in CVC survival-time (P = 0.4). However, the OAW group had more positive CVC tip cultures (OAW 11/14 vs. TAW 2/9; P < 0.05) and a tendency to: (i) more extra dressings (P = 0.08); (ii) more cultures from the exit skin site showing high numbers of colony forming units (P = 0.07); (iii) shorter time to first exit site infection (P = 0.09); and (iv) more Gram-positive septicaemias (P = 0.08). Both clinical and bacteriological data in this study indicate that changing transparent polyurethane CVC bandages twice a week is superior to once a week.
Engervall
P
P
Division of Medicine, Karolinska Hospital, Stockholm, Sweden.
Ringertz
S
S
Hagman
E
E
Skogman
K
K
Björkholm
M
M
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D016470:Bacteremia / Q000209:etiology; D001419:Bacteria / Q000302:isolation & purification; D001458:Bandages; D002405:Catheterization, Central Venous / Q000009:adverse effects / Q000295:instrumentation / Q000451:nursing*; D003428:Cross Infection / Q000209:etiology; D004866:Equipment Contamination; D005260:Female; D006094:Gram-Positive Bacteria / Q000254:growth & development; D006801:Humans; D007938:Leukemia / Q000150:complications; D008297:Male; D008875:Middle Aged; D009503:Neutropenia / Q000150:complications*; D017063:Outcome Assessment, Health Care; D012867:Skin / Q000382:microbiology; D013997:Time Factors