Evaluation of dressing regimens for prevention of infection with peripheral intravenous catheters. Gauze, a transparent polyurethane dressing, and an iodophor-transparent dressing
D. G. Maki and M. Ringer
Department of Medicine, University of Wisconsin Medical School, Madison.
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, 10(0.58) to 10(0.70) colony-forming units). The rate of
local catheter-related infection (greater than or equal to 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.
Treatment of Staphylococcus epidermidis central vascular catheter infection with 70% ethanol locks: efficacy in a sheep model
Chambers et al.
J Antimicrob Chemother 2007;59:779-782.
ABSTRACT
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Evidence-Based Practice in the Management of Vascular Access Devices for Home Parenteral Nutrition Therapy
Ryder
JPEN J Parenter Enteral Nutr 2006;30:S82-S93.
ABSTRACT
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A Vancomycin-Heparin Lock Solution for Prevention of Nosocomial Bloodstream Infection in Critically Ill Neonates With Peripherally Inserted Central Venous Catheters: A Prospective, Randomized Trial
Garland et al.
Pediatrics 2005;116:e198-e205.
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Infection Control in Intensive Care Units
Mohr et al.
Journal of Pharmacy Practice 2005;18:84-90.
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The Impact of Bedside Behavior on Catheter-Related Bacteremia in the Intensive Care Unit
Coopersmith et al.
Arch Surg 2004;139:131-136.
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Comparison of microbial adherence to antiseptic and antibiotic central venous catheters using a novel agar subcutaneous infection model
Gaonkar and Modak
J Antimicrob Chemother 2003;52:389-396.
ABSTRACT
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Guidelines for the Prevention of Intravascular Catheter-Related Infections
O'Grady et al.
Pediatrics 2002;110:e51-51.
ABSTRACT
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Septic discitis and other complications of peripheral venous cannulation
Greig et al.
QJM 2002;95:412-413.
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Is Routine Replacement of Peripheral Intravenous Catheters Necessary?
Bregenzer et al.
Arch Intern Med 1998;158:151-156.
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Patient Factors and Central Line Infection
Rush and Haller
Clin Nurs Res 1995;4:397-410.
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Adaptive Transparent Film Dressings
Dabi et al.
J Biomater Appl 1994;9:14-29.
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