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Central Line Dressings

When a patient has a skin condition, or irritated skin form a Transparent semi-permeable dressing product, what alternate products is everyone out there using that are appropriate?

**I realize that skin irritation can be caused for Chlorahexidine preparations that aren't aloud to dry properly prior to dressing application** These cases are separate from this issue.

Thank you!


How did you know?

What was your findings that lead you to the conclusion that it is indeed the transparent dressing?

Angelo M. Aguila, MSN, RN, VA-BC
Vascular Access Nurse
[email protected]

Chris Cavanaugh
Dressing alternatives

Each manufacture uses different materals to create their dressings and adhesives, and there is no way to find out what is used or what the patient may be having a reaction to.

There are many different dressings on the market, some of which may not cause the same reaction in the patient. 

Try: Sorbaview by TriState, Op-Site by Smith and Nephew and there may be others readily available.

There is always gauze and tape. There is no reason not to use gauze and tape, it will just require changing every 24 to 48 hours. 

Chris Cavanaugh, RN, BSN, CRNI, VA-BC

CVC Dressing Changes



Are you comfortable using gauze and tape dressing on central lines with changes every 24-48 hours?  Don't you think that this increases the risk of CR-BSI?  Thanks for your thoughts.



Lorelle Wuerz BS, RN, MSN

No, gauze and tape vs

No, gauze and tape vs transparent membrane dressing have no difference in the rates of CRBSI. Check CDC guidelines, INS standards, and the many studies from the 1980 and 90's on this issue. Both are acceptable dressing, although the TSM allows for visualization. Lynn

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

Lynn Hadaway Associates, Inc.

126 Main Street, PO Box 10

Milner, GA 30257


Office Phone 770-358-7861

Chris Cavanaugh
Sterile changes needed


In response to your question, the CDC, SHEA and INS guidelines all agree that sterile gauze dressings are an acceptable practice for any central line.  The dressing should be changed every 24-48 hours, depending on patient's condition, dressing condition and which guidelines you choose to follow.  Yes, I feel this is a safe alternatives for those who's skin will not tolerate a TSM dressing for whatever reason, including burn patients.  The use of a Biopatch would help to decrease infection risk, even in these cases.  The dressing must still be done using sterile technique. 

I personally would recommend a Q7 day sterile dressing change with biopatch and a TSM, but if the patient cannot tolerate it, the risk of skin rash and breakdown outweighs the risk of a CLABSI.

It is a clinical decision that should be made using critical thinking skills based on the patient's condition and other related factors. 

Chris Cavanaugh, RN, BSN, CRNI, VA-BC


The recommendation from the manufacuturer of Sorbaview is not to use any other barrier ( no sting cavlon or skin prep) before applying this dressing.

Theresa Reed, RN, BSN

Manager, Vascular Access Team

Texas Children's Hospital

Houston, TX

You can also try prevention

You can also try prevention methods by using a skin protectant solution on each and every patient before all dressing applications. I would never apply a dressing of any type to any patient without using these solutions. SkinPrep, NoSting Barrier plus numerous generics are available. Lynn

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

Lynn Hadaway Associates, Inc.

126 Main Street, PO Box 10

Milner, GA 30257


Office Phone 770-358-7861

Patricia Jean
It was my understanding that

It was my understanding that the guidelines that have lengthened the time a transparent dressing without gauze could remain in place to 7 days was a result of studies that had shown this was superior to more frequent dressing changes which actually "opened up" the site to more contamination due to manipulations.....thus no tape and gauze every 24-48 unless circumstances demanded.   Am I wrong?

Karen Day
Karen Day's picture
patricia,no you are not


no you are not wrong, but I think the key factor here and what you even stated in your reply is that the circmustances that these patients present when they have skin irritation deemed it necessary.   I have seen several instances where the patient has had severe skin irritation.  In most of these instances we did find that it was due to failure to use the skin prep appropriately (allowing for adequate drying time) and re-education helped tremendously, but in a few rare cases, we still had skin issues despite the appropriate application of the skin protectant and we did have to use gauze and tape dressings on these patients.  I have heard that the Molnlycke products are wonderful, but costly and therefore they were not available for us to use. 

Assuming that there are

Assuming that there are several IV S-TM dressings on the market, I would suggest possibly trying another brand product.

Quite often the glues used to improve adherance to the skin can be the irritant as well.

Maybe a change of brand product (if feasible) is a worthwhile option for the patient.


IV3000  (S&N)

Tegaderm (3M)




Timothy R. Spencer, RN, APN, DipAppSci, BH, ICU Cert, VA-BC™
Vascular Access Consultant
That CVC guy from Australia :-}

In addition to skin barrier treatment (e.g. skin prep);

we've had good success with creating a sterile fenestrated duoderm "basement" that doesn't irritate patient's skin, with a tsm dressing on top of that.  You have to be very careful when removing it, but we've had no clabsi with these patients, and the skin improves.  

We don't use this on patient's with open weeping skin - we may opt not to put a picc in at all if we can't put a safe dressing on it.  We will use gauze dressings also, as described in this thread.


Mari Cordes, BS RNIII VA-BC
Vascular Access Department
University of Vermont Medical Center

Peter Marino
Thick duoderm

We have also utilized this method. Mostly on pre-existing skin conditions. I find the thick duoderm to be better than the thin. We have used it on weeping conditionds. If I remeber the insert information correctly, duoderm may stay on for 7 days also.

Peter Marino R.N. BSN CRNI VA-BC Hospital based staff R.N. with no affiliation to any product or health care company.

Susan Rainey
Silicone PICC dressing

See my post in response to topic, "Strange Skin Reaction" regarding the use of silicone dressings for pts with skin irritation. You may find it helpful.

Sue Rainey, RN

Olympic Medical Center

P.S. I'm not a representative for the company mentioned in my post.

Susan Rainey RN, Olympic Medical Center

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