A silver-alginate-coated dressing to reduce peripherally inserted central catheter (PICC) infections in NICU patients: a pilot randomized controlled trial.
OBJECTIVE
Our aim was to evaluate the safety of a silver-alginate-containing dressing to reduce peripherally inserted central catheter (PICC) infections in neonatal intensive care unit (NICU) patients.


METHODS
Patients were randomized 3:1 to receive a patch containing silver, alginate and maltodextrin or standard of care. Patches were placed under the regular transparent retention dressing at the PICC exit site at insertion and were replaced with every dressing change at least every 2 weeks until PICC discontinuation. All study infants were monitored for adverse skin reactions.


RESULTS
A total of 100 infants were followed up for 1922 person-days, including 75 subjects with 89 PICCs who received the patch. The median birth weight (1330 g) and median gestational age (30 weeks) was lower in the patch group when compared with the controls (P=0.001 and 0.005, respectively). Study patients received the patch with their PICC at a median age of 5 days; the patch stayed in place for a median of 13 days. We noted no adverse skin reactions and found no evidence that the patch alters the microbiology of PICC-associated infections.


CONCLUSIONS
This pilot trial suggests that silver-alginate-coated dressings are skin safe and their inclusion in future trials aimed at reduction of PICC-associated bloodstream infections in the NICU should be considered.
Hill
M L
ML
Division of Neonatology, Department of Pediatrics, Vanderbilt University School of Medicine and Monroe Carell Jr Children's Hospital at Vanderbilt, Nashville, TN 37232-0656, USA.
Baldwin
L
L
Slaughter
J C
JC
Walsh
W F
WF
Weitkamp
J-H
JH
D000279:Administration, Cutaneous; D000464:Alginates / Q000008:administration & dosage; D000900:Anti-Bacterial Agents / Q000008:administration & dosage*; D001458:Bandages; D002405:Catheterization, Central Venous / Q000009:adverse effects*; D002408:Catheters, Indwelling / Q000009:adverse effects*; D005260:Female; D020723:Glucuronic Acid / Q000008:administration & dosage; D006603:Hexuronic Acids / Q000008:administration & dosage; D006801:Humans; D007231:Infant, Newborn; D008297:Male; D010865:Pilot Projects; D011134:Polysaccharides / Q000008:administration & dosage; D018805:Sepsis / Q000517:prevention & control*; D012834:Silver / Q000008:administration & dosage; D016896:Treatment Outcome
D000464:Alginates; D000900:Anti-Bacterial Agents; D006603:Hexuronic Acids; D011134:Polysaccharides; D012834:Silver; C008315:maltodextrin; D020723:Glucuronic Acid