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Gauze, a Transparent Polyurethane Dressing, and an lodophor-Transparent Dressing

Dennis G. Maki, MD; Marilyn Ringer, BSN

JAMA. 1987;258(17):2396-2403.

Abstract
Four dressing regimens for peripheral venous catheters were studied in a prospective randomized clinical trial with 2088 Teflon catheters: (1) sterile gauze, replaced every other day, and three dressings left on for the lifetime of the catheter; (2) gauze; (3) a transparent polyurethane dressing; and (4) an iodophor-transparent dressing. The four dressings provided comparable coverage, except moisture accumulated more frequently under the transparent dressings 26% to 28% vs 20% to 21% Cutaneous colonization under the dressing was low level and comparable with all four dressings (range, 100.58 to 100.70 colony-forming units). The rate of local catheter-related infection 15 colony-forming units) was also low and did not differ significantly (range, 4.6% to 5.9%); no catheter caused bacteremia. Stepwise logistic multivariate analysis showed cutaneous colonization of the insertion site (relative risk [RR] of infection, 3.86), contamination of the catheter hub (RR, 3.78), moisture under the dressing (RR, 2.48), and prolonged catheterization (RR, 1.75) to be significant risk factors for catheter-related infection. These data indicate that it is not cost-effective to redress peripheral venous catheters at periodic intervals; for most patients, either sterile gauze or a transparent dressing can be used and left on until the catheter is removed.

(JAMA 1987;258:2396-2403)

Author Affiliations
From the Section of Infectious Diseases, Department of Medicine, University of Wisconsin Medical School, and the Infection Control Department, University of Wisconsin Hospitals and Clinics, University of Wisconsin, Madison.

Footnotes
Presented in part at the 58th Annual Meeting of the Central Society for Clinical Research and the Midwestern Section of the American Federation for Clinical Research, Chicago, Nov 8, 1985.

An abstract of this article was previously published in Clinical Research (1985;33:845A).

Reprint requests to H4/574, University of Wisconsin Hospital and Clinics, Madison, WI 53792 (Dr Maki).

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