CVC dressing change-- is this a gauze or transparent dressing?

[actioncat]

Ok, the kit has some opsite, but it also has a little piece of gauze to put around the insertion site. Is this considered a transparent dressing or a guaze dressing?

[yashalag]

In our Facility, we are NOT allowed to use the 2x2.

We usze a biopatch & place a tegaderm over.

Our dsgs are changed every 7 days & prn.

We must be able to see the site & assess it.

However, if a pt needs a gauze dsg instead of transparant, it must be changed DAILY.

Same at my facility. Gauze is usually placed immediately after insertion, then must be changed to a tegaderm within 24 hours of insertion. Then, it become a qWeek dressing change. If it is an oozy site, gauze can be placed, but must be changed daily. If that is necessary, though, you would have to wonder why it was still oozing after the first day or so.

[iluvivt, BSN, RN]

The minute you put gauze at the insertion site and under the transparent semi-permeable membrane (TSM) dressing it automatically makes it a gauze dressing. INS reccommends that any gauze dressing on a CVC or PICC be left in place for a maximum of 48 hours. It is OK to apply the gauze (usually some 2x2s) if you need it (smAll amt of non-purulent drainage) but then realize that the TSM dressing is just another form of tape.

The rational behind this is that gauze placed under this type of dressing will have greater growth of bacteria then just the use of the TSM dressing applied without any gauze. The use of gauze can also affect the moisture vapor permeable rate of transmission. Many of these dressing are designed to keep moisture vapor low,thus decreasing infection risk.

So the bottom line is use the gauze at the site ONLY IF YOU NEED IT FOR A CLINICAL REASON. It is OK to pad the skin with it as long as it is not under the TSM. Much better to use a Biopatch then the TSM or the TSM with the CHG patch. It can get very complicated and there is much research on this subject but on this issue the CDC and INS agree....its a 48 hour max on this type of dressing. Some hospitals will put a gauze dressing on new CVCs or PICCs and change that in 24 hours.....we extended it to 48 hours b/c we wanted to make sure all insertion related oozing had stopped. Hope this clears it up! Mary

[blondy2061h, MSN, RN]

We use gauze over mediports, just cause they're so big and at risk of getting bumped, but not on our CVL dressings, just Tegaderm and a biopatch on there.