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All our central and picc line dressing kits have 2x2 gauze in them. We also use a "Biopatch" on them. Personally, when I change a CVC or picc dressing, I will use the sterile gauze by placing it between the catheter and the skin if I see evidence of irritation from friction, etc. I do not like to place it over the insertion site, because I then cannot see it. The biopatch is smaller, so I can still visualize the site through the transparent opsite dressing. I can see if the line has moved and measure the length, as well as assess for signs of infection, etc. Only if its a newly inserted site do we use gauze as sometimes they will ooze, and the gauze allows us to measure the amount of bleeding.
My understanding is that is you have a site covered with opsite, it is transparent, but I have seen dressings that were covered in such a way that even with opsite, there was no visibility of the site due to the amount/size of the gauze. You can see if the gauze has drainage, but you can't see the site.
Hope this helps.
You might want to check out your hospital's policy.
In the hospital that that work in, it is policy to place a 2X2 sterile gauze over the CVC insertion site whether it be covered by a covaderm, duoderm, or tegaderm. It is also policy to place a single folded sterile 2X2 guaze between the cvc "wing" and the patient's skin.
I had a recent oozer that just would not quit (high INR). So I got a buddy to glove up too, and put the biopatch where it goes (around the insertion site but not under the catheter so you can pull it up without pulling the catheter out). Then my buddy took a sterile 4x4, rolled it up into a little thing about an inch by half inch, and held it ... to one side of the catheter while I applied the dressing. The side would be "bottom" if the person were standing or sitting, which she wasn't. But since we raised the HOB it helped catch the ooze and apply a tiny bit of pressure at the same time. Also the second half of the dressing, that's supposed to surround the piggytails, I used to reinforce the bottom end instead, so the ooze would take longer to soak through. Lasted almost to the end of my shift.
Where I work if you use the 2x2 under the opsite( or other transparent dressing) then it is not considered as occlusive and has to be changed more frequently. I am not sure off the top of my head but it might be daily as oppose to every 7 days or if becomes non occlusive. It is pretty rare to see a 2x2 under an opsite for this reason.
I know this is an old thread but wanted to give my 2 cents. Any time you put gauze under a transparent dressing the maximum time this should stay on is 48 hours. This is also an INS recommendation. The reason is that multiple studies have shown that bacteria counts increase more quickly with the presence of gauze. However, there are times when it must be used as in the first dressing placed after line placement or site keeps oozing. When able switch to the transparent dressing that you have available without gauze under it, biopatch if you have it. You can use the gauze under tape to secure tails. This type of dressing can often stay in place for up to 7 days ,but of course follow your employers policies.
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.