Once- versus twice-weekly changing of central venous catheter occlusive dressing in intensive chemotherapy patients: results of a randomized multicenter study.
BACKGROUND
Changing a central venous catheter occlusive dressing on a twice-weekly basis is usually recommended in hemato-oncological patients. A longer interval is believed to give rise to infections. However, frequent dressing changes might cause local cutaneous damage.


METHODS
Local cutaneous damage and infections were compared in patients with once-weekly versus twice-weekly changes of central venous catheters occlusive dressings. This was a prospective, randomized, multicenter trial.


RESULTS
Eighty-one patients with acute myeloid leukemia being treated with intensive chemotherapy were enrolled (twice-weekly group: n=42, once-weekly group: n=39). They had a non-tunneled polyurethane central venous catheter inserted into the vena subclavia and the insertion site was covered by a polyurethane semi-permeable occlusive dressing. No differences were observed between the groups with respect to local cutaneous damage, fevers, or positive catheter blood cultures. There were more insertion-site inflammations in the twice-weekly group (55% vs. 25%, p=0.008). In the once-weekly group it was necessary to change the occlusive dressing sooner in 42% of the cases, mostly due to a soiled dressing and local bleeding, and the real mean interval of changes was 5.4 days.


CONCLUSIONS
Prolonging the frequency of occlusive dressing change to a once-weekly interval was limited by an increasing number of unplanned dressing changes. The prolonged interval of dressing changes, with a real mean interval of 5.4 days, did not lead to an increased number of local cutaneous complications or central venous catheter blood culture positivity and even contributed to reduced insertion-site inflammation occurrence.
Vokurka
Samuel
S
Department of Hemato-Oncology, University Hospital in Plzen (Pilsen), Plzen, Czech Republic. vokurka@fnplzen.cz
Bystricka
Eva
E
Visokaiova
Maria
M
Scudlova
Jana
J
D055499:Catheter-Related Infections / Q000097:blood / Q000150:complications / Q000382:microbiology; D002405:Catheterization, Central Venous / Q000009:adverse effects; D005260:Female; D005334:Fever / Q000150:complications; D006801:Humans; D007249:Inflammation / Q000150:complications; D015470:Leukemia, Myeloid, Acute / Q000150:complications / Q000188:drug therapy*; D008297:Male; D008875:Middle Aged; D009779:Occlusive Dressings / Q000009:adverse effects; D010146:Pain / Q000150:complications; D012867:Skin / Q000473:pathology; D013997:Time Factors