 |
|
Transparent Polyurethane Film as an Intravenous Catheter DressingA Meta-analysis of the Infection Risks
Karen K. Hoffmann, MS;
David J. Weber, MD, MPH;
Gregory P. Samsa, PhD;
William A. Rutala, PhD, MPH
JAMA. 1992;267(15):2072-2076.
Abstract
| |
Objective.
—To obtain a quantitative estimate of the impact on infectious complications of using transparent dressings with intravenous catheters.
Data Sources.
—Meta-analysis of all studies published in the English literature, including abstracts, letters, and reports that examined the primary research question of infection risks associated with transparent compared with gauze dressings for use on central and peripheral venous catheters. Studies were identified by use of the MEDLINE database using the indexing terms occlusive dressings, transparent dressings, and infection and by review of referenced bibliographies.
Study Selection.
—Seven of the 15 studies (47%) of central venous catheters and seven of 12 studies (58%) of peripheral catheters met our inclusion criteria for analysis. All studies used a prospective cohort design, utilized hospitalized patients, and reported at least one of our defined outcomes.
Extraction.
—Data for each study were abstracted independently by three investigators. At least three studies were used in the analysis of each outcome.
Data Synthesis.
—Applying a Mantel-Haenszel  2 analysis, use of transparent dressings on central venous catheters was significantly associated with an elevated relative risk (RR) of catheter tip infection (RR = 1.78; 95% confidence interval [CI], 1.38 to 2.30). Catheter-related sepsis (RR = 1.69; 95% CI, 0.97 to 2.95) and bacteremia (RR = 1.63; 95% CI, 0.76 to 3.47) were both associated with an elevated RR. Use of transparent dressings on peripheral catheters was associated with an elevated RR of catheter-tip infection (RR=1.53; 95% CI, 1.18 to 1.99) but not phlebitis (RR = 1.02; 95% CI, 0.86 to 1.20), infiltration (RR = 1.12; 95% CI, 0.92 to 1.37), or skin colonization (RR =0.99; 95% CI, 0.90 to 1.09).
Conclusion.
—The results demonstrated a significantly increased risk of catheter-tip infection with the use of transparent compared with gauze dressings when used with either central or peripheral catheters. An increased risk of bacteremia and catheter sepsis associated with the use of transparent compared with gauze dressings for use on central venous catheters was suggested.
(JAMA. 1992;267:2072-2076)
Author Affiliations
From the Division of Infectious Diseases, Department of Medicine, University of North Carolina at Chapel Hill (Ms Hoffmann and Drs Weber and Rutala); the Department of Hospital Epidemiology, University of North Carolina Hospitals, Chapel Hill (Drs Weber and Rutala); and the Center for Health Services Research in Primary Care, Division of Biometry and Medical Informatics, Department of Community and Family Medicine, Duke University, Durham, NC (Dr Samsa).
Footnotes
Presented in part at the Third International Conference on Nosocomial Infections, Atlanta, Ga, August 2, 1990.
Reprint requests to Division of Infectious Diseases, CB#7030, Burnett-Womack 547, University of North Carolina at Chapel Hill, Chapel Hill, NC 27599-7030 (Ms Hoffmann),
 CiteULike  Connotea  Del.icio.us  Digg  Reddit  Technorati  Twitter
What's this?
THIS ARTICLE HAS BEEN CITED BY OTHER ARTICLES
|
The Impact of Hospital Practice on Central Venous Catheter Associated Bloodstream Infection Rates at the Patient and Unit Level: A Multicenter Study
Kritchevsky et al.
American Journal of Medical Quality 2008;23:24-38.
ABSTRACT
Colonization and Bloodstream Infection with Single- Versus Multi-Lumen Central Venous Catheters: A Quantitative Systematic Review
Zurcher et al.
Anesth. Analg. 2004;99:177-182.
ABSTRACT
| FULL TEXT
The Impact of Bedside Behavior on Catheter-Related Bacteremia in the Intensive Care Unit
Coopersmith et al.
Arch Surg 2004;139:131-136.
ABSTRACT
| FULL TEXT
Guidelines for the Prevention of Intravascular Catheter-Related Infections
O'Grady et al.
Pediatrics 2002;110:e51-51.
ABSTRACT
| FULL TEXT
Influence of Triple-Lumen Central Venous Catheters Coated With Chlorhexidine and Silver Sulfadiazine on the Incidence of Catheter-Related Bacteremia
Heard et al.
Arch Intern Med 2001;158:81-87.
ABSTRACT
| FULL TEXT
The health professional's role in preventing nosocomial infections
Saloojee and Steenhoff
Postgrad. Med. J. 2001;77:16-19.
ABSTRACT
| FULL TEXT
Prevention of Intravascular Catheter-Related Infections
Mermel
ANN INTERN MED 2000;132:391-402.
ABSTRACT
| FULL TEXT
Prospective Evaluation of Risk Factors for Bloodstream Infection in Patients Receiving Home Infusion Therapy
Tokars et al.
ANN INTERN MED 1999;131:340-347.
ABSTRACT
| FULL TEXT
Cost-Effectiveness of Antiseptic-Impregnated Central Venous Catheters for the Prevention of Catheter-Related Bloodstream Infection
Veenstra et al.
JAMA 1999;282:554-560.
ABSTRACT
| FULL TEXT
Catheter Infections: Diagnosis, Etiology, Treatment, and Prevention
Krzywda et al.
Nutr Clin Pract 1999;14:178-190.
ABSTRACT
Decreasing Catheter Colonization Through the Use of an Antiseptic-Impregnated Catheter: A Continuous Quality Improvement Project
Collin
Chest 1999;115:1632-1640.
ABSTRACT
| FULL TEXT
Outpatient Parenteral Antimicrobial-Drug Therapy
Gilbert et al.
NEJM 1997;337:829-839.
FULL TEXT
Care of Central Venous Catheters for Total Parenteral Nutrition
Collins et al.
Nutr Clin Pract 1996;11:109-115.
ABSTRACT
Invited Review: Vascular Access Devices: Perspectives on Designs, Complications, and Management
Evans and Ryder
Nutr Clin Pract 1993;8:145-152.
ABSTRACT
Detection and Prevention of Central Venous Catheter-Related Infections
Kruse and Shah
Nutr Clin Pract 1993;8:163-170.
ABSTRACT
Transparent Polyurethane Film as a Catheter Dressing
Berry
JAMA 1992;268:2514-2515.
ABSTRACT
|
