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hkerr
Definition of healed exit site for tunneled, cuffed CVAD

Hi All,

Although the term "healed exit site" is used in the literature, I have not come across a formal definition.  I'd be interested to hear if anyone knows of such a definition and/or what your thoughts are on how one should confirm a tunneled CVAD exit site is officially "healed". 

Thanks!

Holly Kerr, RN (Vancouver)

lynncrni
 I don't think I have ever

 I don't think I have ever seen this defined in detail but this is what I would consider to be a healed site:

SC cuff is firmly in tissue and will not move with a slight gentle tug

Absense of all signs of inflammation at exit or along tunnel

Absence of all signs/symptoms of any complication at exit or along tunnel

What is meant is a cuff that is placed correctly and the SC tissue has grown into it so that it acts as an anchor and a barrier to skin organisms. This period is different for each patient. Lynn

Lynn Hadaway, M.Ed., RN, NPD-BC, CRNI

Lynn Hadaway Associates, Inc.

PO Box 10

Milner, GA 30257

Website http://www.hadawayassociates.com

Office Phone 770-358-7861

hkerr
Thanks very much for your

Thanks very much for your comments Lynn!  Do you think there needs to be a circumferential skin seal aroud the catheter at the exit site (i.e. no little gaps) in order for the site to be considered "healed", in addition to the features you have already listed?  Best wishes, Holly

lynncrni
 No, the subq tissue will not

 No, the subq tissue will not usually adhere to the catheter wall itself. So this gap will almost always be present. Lynn

Lynn Hadaway, M.Ed., RN, NPD-BC, CRNI

Lynn Hadaway Associates, Inc.

PO Box 10

Milner, GA 30257

Website http://www.hadawayassociates.com

Office Phone 770-358-7861

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