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information on central line dressing changes

Wondering if anyone has any evidence bbased information on when to change a central line dressing outside the normal time frames (7 days for Tegaderm, etc.). When there is drainage (dried or bloody) -  and the dressing is intact-how much drainage is acceptable? Are we opening patients up for greater risk of infection and skin problems with repeated dressing changes even for a nickel sized area at insertion site of dried blood. Plus - who is to say that we won't get the site oozing again when doing the site cleansing. We are trying to come up with some guidelines for the nurses. Thanks in advance!

Have you tried using

Have you tried using Biopatch?
The instructions for use state that the Biopatch can absorb eight times its weight in fluid.

That might help to absorb the small amounts of drainage you are referring to.
/Tess Hopkins

I have never seen any

I have never seen any evidence to support any amount of drainage as being acceptable. You would need to know what type of drainage. If it is blood, then is it from the insertion procedure or longer in the dwell? There are hemostatic dressings that can be used to stop this bleeding. Any amount of blood will add to the risk of infection because those organisms on the skin will grow nicely in that blood. If it is fluid leakage from the infusion, there is a serious problem with the catheter- a damaged catheter or a fibrin sheath causing retrograde flow and the possibility of an infiltration/extravasation. If it is purulent drainage, it should be cultured, notify the doctor, remove the catheter and insert another. Excessive perspiration could appears as drainage and there are other things that can causes drainage such as chyle, or lymphatic drainage, which can look like purulent drainage. So, in my opinion, all drainage must be assessed and corrected. 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

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