In need of recommendations

[wheeliesurfer]

I have a home health patient who has a PAS-Port for home hydration and IV abx prn d/t frequent UTI's. The patients port is accessed 24/7 since they do nightly hydration (it is a supplement to their oral intake, but they are unable to get 100% oral intake accomplished d/t N/V).

The trouble has come that this patient has many allergies including to latex and adhesives. When we started out they could use paper tape and tegaderm, so the tegaderm was used to cover the access site. Then they started to react to the tegaderm (blistering and welting) so we switched to Sorba-View. That worked for a few months, and now they are reacting the same way to the Sorba-View.

I have thought about trying Prima pore, but have not gone that route because you can't visualize the access site and the patient would have to do a mid week dressing change on their own.

Do any of you IV nurses have ideas on skin friendly drsg's to use on pt's with multiple allergies? My next (and maybe last?) idea is to try the prima pore and see if their skin can tolerate that, but I would really like to maintain visualization of the site.

Are there any drsg's that are more of a gel type adhesive instead of a sticker type adhesive? They seem to do alright with wound care drsgs that are gel based.

I know you can't give medical advice particular to this patient, but maybe you could share your past experiences with patients you have dealt with who also had many sensitivities and what worked for them.

Thanks for your stories. Anything to get my mind working again towards possible solutions.

[HMarie13]

Are they actually allergic to the dressing or could it be to the cleaning solution used?

The reason I say that I have had patients tell me that they are allergic to a tegaderm but it actually turned out they were allergic to the CHG prep we used to clean around the site.

I would double check and make sure none of the soulutions are causing the irritation.

I don't use anything but tegaderms so I'm no help with they are truly allergic to them.

Good luck!

[Asystole RN]

The majority of the time the reactions to the dressings are not from the adhesive or the dressing materials but from stretching the dressing when placing it and not allowing for a full 3 minute drying time for the CHG. Allowing for a full 3 minute dry time and applying skin prep work wonders.

I have had to use gauze dressings in the past, you just have to change them every 24-48hrs depending upon policy.