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	Since this article does not have an abstract, we have provided the first 150 words of the full text and any section headings.

To the Editor: In their randomized controlled trial, Dr Timsit and colleagues¹ concluded that use of a chlorhexidine gluconate–impregnated sponge (CHGIS) at the catheter insertion site may reduce catheter-related infections (CRIs). Moreover, extending the interval for dressing changes from 3 to 7 days had noninferior results. Because catheter insertion is applied to patients with severe injury or critical illness, physicians in intensive care units need to consider the effect of the injury or disease on selection of the insertion sites.

For example, for patients with lower limb amputation, contralateral femoral vein insertion would likely result in an increased catheter colonization rate. This would also occur in patients with burns in the craniofacial area receiving jugular or subclavian vein insertion. However, in analyzing the data, the authors did not consider the distance between the wound sites and the insertion sites. They also did not consider other factors such as the nutritional . . . [Full Text of this Article]

Yong-Gang Lv, MD
lvygwyt@tom.com
Department of the Third General Surgery
Xijing Hospital
Xi’an, China

Hong-Lin Dong, MD
Department of General Surgery
Second Hospital of Shanxi Medical University
Taiyuan, China

Ling Wang, MD
Department of the Third General Surgery
Xijing Hospital

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RELATED ARTICLE

Chlorhexidine-Impregnated Sponges and Less Frequent Dressing Changes for Prevention of Catheter-Related Infections in Critically Ill Adults: A Randomized Controlled Trial
Jean-François Timsit, Carole Schwebel, Lila Bouadma, Arnaud Geffroy, Maïté Garrouste-Orgeas, Sebastian Pease, Marie-Christine Herault, Hakim Haouache, Silvia Calvino-Gunther, Brieuc Gestin, Laurence Armand-Lefevre, Véronique Leflon, Chantal Chaplain, Adel Benali, Adrien Francais, Christophe Adrie, Jean-Ralph Zahar, Marie Thuong, Xavier Arrault, Jacques Croize, Jean-Christophe Lucet, and for the Dressing Study Group
JAMA. 2009;301(12):1231-1241.
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RELATED LETTERS

Chlorhexidine-Impregnated Sponges and Prevention of Catheter-Related Infections
Jean-Jacques Parienti
JAMA. 2009;302(4):379.
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Chlorhexidine-Impregnated Sponges and Prevention of Catheter-Related Infections—Reply
Jean-François Timsit, Adrien Francais, and Jean-Christophe Lucet
JAMA. 2009;302(4):380.
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