Reduction of bacterial colonization at the exit site of peripherally inserted central catheters: A comparison between chlorhexidine-releasing sponge dressings and cyano-acrylate. Issue 4 (July 2021)

• Record Type: Journal Article
• Authors: Gilardi, Emanuele; Piano, Alfonso; Chellini, Pietro; Fiori, Barbara; Dolcetti, Laura; Pittiruti, Mauro; Scoppettuolo, Giancarlo
• Is Part Of: Journal of vascular access. Volume 22:Issue 4(2021)
• Page Start: 597
• Page End: 601
• Publication Date: 2021-07
• Subjects: Biopatch -- chlorhexidine-releasing sponge dressing -- cyanoacrylate glue -- extra-luminal colonization -- Peripherally Inserted Central Catheters (PICC); Arterial catheterization -- Periodicals; Intravenous catheterization -- Periodicals; 612.13
• DOI: 10.1177/1129729820954743
• Languages: English
• ISSNs: 1129-7298

Abstract

Introduction: A serious complication associated with Central Venous Access Device (CVAD) is infection because of bacterial contamination, either by the extra-luminal or by the intra-luminal route. We evaluated the efficacy, the safety, and the cost-effectiveness of two strategies for non-inferiority in controlling bacterial colonization of the exit-site of Peripherally-Inserted Central Catheters (PICC). Methods: After PICC placement, a skin swab of the exit site was taken and cultured. In group A the exit site was sealed with N-butyl-cyanoacrylate glue, while in group B a chlorhexidine-releasing sponge dressing was applied. A second skin culture was taken at day 7. Results: A total of 51 patients were enrolled in each group. In 42 patients the second skin culture was not performed because of 20 patients were lost at follow-up or deceased and in 22 patients the dressing needed to be changed early, because of local bleeding (13 cases, in group B) or because of dressing detachment (four in group A and five in group B). The microbiological study was completed in 36 patients in group A and 24 in group B. No microorganisms were isolated in any patient. Conclusions: Both strategies were effective in controlling bacterial colonization. Glue was effective in reducing local bleeding, and it was more cost-effective than sponge dressing. During the first week, when local bleeding and bacterial colonization must be prevented, glue might be more appropriate than chlorhexidine-releasing dressing; after the first week chlorhexidine-releasing dressing might be preferable, considering that the safety of glue application on the skin for prolonged periods is still questionable.