The Impact of Early Dressing Removal on the Tunneled Central Venous Catheters

Background: There were many studies compared between different types of dressing such as chlorhexidine gluconate gel (CHG), (CHG) disc, gauze dressing and transparent dressing regarding its intact to the skin, infection rate and patients satisfaction. However, there was few studies regarding the impact of removing the dressing on the occurrence of exit site infection of tunneled central venous catheters. Aim: The objective of the current study was to evaluate the impact of early central venous catheter (CVC) dressing removal of the well-healed exit site infections. Methods: It was a quasi-experiment pilot study conducted over 15 months duration in a specialized oncology center. All adult patients who had newly inserted tunneled central venous catheters (CVC) in place were recruited. Patients were distributed to control and experimental group based on first come first served. Patients in the control group (n=8) received the standard protocol of applying (CVC) dressing, while patients in the interventional group (n=8) received the protocol of no dressing. Results: There was no significant difference in the infection rate between the two groups ( P = 1), so that, a total of two cases had developed catheter-related bloodstream infection (CLABSI), one in the control group and the other in the interventional group. Moreover, one patient in the interventional group had developed exit site infection. However, patients with no dressing protocol (interventional group) perceived an improvement in their quality of life and they were satisfied with this protocol. Conclusion: Applying no dressing protocol to a well-healed exit site CVCs showed encouraging results in terms of exit site and bloodstream infections. That is to say; it did not predispose patients to increased risk of infections. Furthermore, patients with no dressing protocol feel more comfortable in their lifestyle.