Has anyone heard of or been using a product called ExSept by Alcavis for dressing change/site care for PICC lines? The dialysis coordinator at our pediatric facility says they have changed to it because it stings less than chloraprep so the kids are more comfortable during dressing change for their dialysis catheter care. They are also using it for port site disinfection prior to access. The bottle she showed me was a multi-use spray bottle. She states their line infection rate has decreased since using it. Anyone have any experience?
Thanks
Holly Hess
This product is not new as it has been on the market for at least 10 years, and I think longer than that. It has always been advertised within the dialysis community. And I am not aware of any studies supporting its use for reducing CRBSI. And neither the CDC nor INS included it in their documents just updated last year. The antiseptic is sodium hypochlorite and their labeling includes CVC dressing changes. I would be hesitant to move away from CHG since that comes so highly recommended from CDC and it does have studies to support its outcomes. I just looked at their website and did not find any links to clinical studies examining outcomes with CRBSI. Lynn
Lynn Hadaway, M.Ed., RN, CRNI
Lynn Hadaway Associates, Inc.
PO Box 10
Milner, GA 30257
Website http://www.hadawayassociates.com
Office Phone 770-358-7861
I've been taught to keep away from spray bottles as contamination and growth can occur within the spray mechanism which cant be cleaned, and that it was possible for bacteria to enter down the spray spout and go back down the tubing.. I also dont like the thought of sod hypochlorite to be sprayed around the air I am breathing in..
Maybe I am horribly wrong, but it doesnt sound like the great magical replacement solution.
We have a patient who is 'allergic' to chlorhexidine, has a PICC line, and came to us already using ExSept. I was very sceptical at first, for many of the same reasons listed below. We specifically don't have this solution in a spray bottle (again refer below). We clean the container with alcohol prior to pouring the solution onto a sterile gauze for site cleansing. This patient has not had any problems and has had his line for about 9 months now. This is certainly not a trial by any means, but for this patient, it has worked and we don't seem to have found a down side at this point. We did get a specific order from the MD, since this is not in accordance with our policy.
Janine Pritchett, RN-BC, BSN, VA-BC
Clinical Educator - Vascular Access