Chlorhexidine 2% and choice of transparent dressing increase skin reactions at central venous catheter insertion sites

Loewenthal, Mark; Dobson, Paul D.; Boyle, Michael

doi:10.1016/j.ajic.2016.06.020

Cited by 7 publications

(2 citation statements)

References 10 publications

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“…As a commonly used antiseptic agent, CHG has been used in intensive care units (ICU) for routine daily care, and its use has been shown to decrease the incidence of CRBSI. [61–63] Some studies have shown that CHG-impregnated dressings reduce the incidence of CRBSI. [62,64,65] The study by Karpanen suggested that CHG-impregnated dressings have detectable antimicrobial activity for up to 7 days, and the sustained release of CHG from the dressing increases with time, which may reduce the microbial load at the catheter insertion site, thereby reducing the risk of CRBSI.…”

Section: Discussionmentioning

confidence: 99%

Comparative efficacy of 13 antimicrobial dressings and different securement devices in reducing catheter-related bloodstream infections

Dang¹,

Li²,

Tian³

2019

Medicine

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Purpose: The purpose of our study is to carry out a Bayesian network meta-analysis comparing the efficacy of different antimicrobial dressings for prevention of catheter-related blood infections (CRBSI) and rank these antimicrobial dressings for practical consideration. Methods: We searched the PubMed, Cochrane library, Embase, earlier relevant meta-analysis and reference lists of included studies for randomized controlled trials (RCTs) that compared dressings for prevention of CRBSI. Two authors independently extracted data from each included RCT according to a predesigned Excel spreadsheet and assessed the methodological quality of included RCTs using the Cochrane risk of bias tool. Data was analyzed using the WinBUGS (V.1.4.3) and the Stata (V.15.0). Results: Finally, 35 RCTs involving 8494 patients and evaluating 13 dressings were included. Network meta-analysis showed that transparent dressing may be the best way to prevent CRBSI. Suture and bordered polyurethane dressing might have the lowest risk of CRBSI rate per 1000 catheter-days, and sutureless securement device might lead to the lowest incidence of catheter failure. Conclusions: This network meta-analysis indicated that transparent dressings may be selected for the prevention of CRBSI in patients with central venous catheters, which is of importance in future research. Although evidence is scant, more attention should be paid to head-to-head comparisons of the most commonly used dressings in this field.

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Section: Discussionmentioning

confidence: 99%

Comparative efficacy of 13 antimicrobial dressings and different securement devices in reducing catheter-related bloodstream infections

Dang¹,

Li²,

Tian³

2019

Medicine

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“…The cutaneous toxicity of chlorhexidine has mainly been observed during repeated applications in neonates (impregnated dressings) [222]. In a study of chlorhexidine dressings in a population of adults and children, the 2% concentration was shown to be more aggressive than 0.5% [223]. Finally, in the study conducted by Mimoz et al higher rates of skin reactions were observed with chlorhexidine than with povidone [26].…”

Section: Expert Opinionmentioning

confidence: 99%

Expert consensus-based clinical practice guidelines management of intravascular catheters in the intensive care unit

Timsit

Baleine

Bernard

et al. 2020

Ann. Intensive Care

127

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The French Society of Intensive Care Medicine (SRLF), jointly with the French-Speaking Group of Paediatric Emergency Rooms and Intensive Care Units (GFRUP) and the French-Speaking Association of Paediatric Surgical Intensivists (ADARPEF), worked out guidelines for the management of central venous catheters (CVC), arterial catheters and dialysis catheters in intensive care unit. For adult patients: Using GRADE methodology, 36 recommendations for an improved catheter management were produced by the 22 experts. Recommendations regarding catheter-related infections’ prevention included the preferential use of subclavian central vein (GRADE 1), a one-step skin disinfection(GRADE 1) using 2% chlorhexidine (CHG)-alcohol (GRADE 1), and the implementation of a quality of care improvement program. Antiseptic- or antibiotic-impregnated CVC should likely not be used (GRADE 2, for children and adults). Catheter dressings should likely not be changed before the 7th day, except when the dressing gets detached, soiled or impregnated with blood (GRADE 2− adults). CHG dressings should likely be used (GRADE 2+). For adults and children, ultrasound guidance should be used to reduce mechanical complications in case of internal jugular access (GRADE 1), subclavian access (Grade 2) and femoral venous, arterial radial and femoral access (Expert opinion). For children, an ultrasound-guided supraclavicular approach of the brachiocephalic vein was recommended to reduce the number of attempts for cannulation and mechanical complications. Based on scarce publications on diagnostic and therapeutic strategies and on their experience (expert opinion), the panel proposed definitions, and therapeutic strategies.

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Dressings for the central venous catheter to prevent infection in patients undergoing hematopoietic stem cell transplantation: a systematic review and meta-analysis

Silveira

Reis

Ferreira

et al. 2019

Support Care Cancer

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Chlorhexidine 2% and choice of transparent dressing increase skin reactions at central venous catheter insertion sites

Cited by 7 publications

References 10 publications

Comparative efficacy of 13 antimicrobial dressings and different securement devices in reducing catheter-related bloodstream infections

Comparative efficacy of 13 antimicrobial dressings and different securement devices in reducing catheter-related bloodstream infections

Expert consensus-based clinical practice guidelines management of intravascular catheters in the intensive care unit

Dressings for the central venous catheter to prevent infection in patients undergoing hematopoietic stem cell transplantation: a systematic review and meta-analysis

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