Clear drainage and skin irritation under a picc dressing caused by possibly the dressing and not using skin prep? How should I get the skin to return to normal? So far, I have let her know to make sure to use skin prep with every dressing change and switch from Tegaderm to Sorbaview.
I am assuming you meant wetness under the dressing. Yes all solutions must be thorouglhy dry before applying any adhesive device. Since you did not describe what it looks like, you would need to assess several factors. Where is the irritation noticed in relationship to where the adhesive securement and dressing is located? Does it extend beyond the area of the adhesive dressing and if so, did your CHG application go beyond the dressing where the irritation is seen. You are probably seeing MARSI - medical adhesive related skin injury. It is caused by wet solutions under the dressing, not applying the dressing according to manufactuerer IFU, etc. Skin protectant solution is necessary fron the beginning for all dressings to prevent this and maintain skin integrity. Switching dressing may or may not help. Make sure to use an acohol free skin protection solution as the ones with alcohol and be painful to apply to irritated skin. There is a lot about this in the 2021 INS Standards inclding a new standard on Catheter Associated Skin Injury. Please read that for much more information.
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