PICC dsg's with gauze

IVRUS, BSN, RN · Aug 13, 2007

I know INS say's if there is gauze under a tegaderm dsg then it is a gauze dsg. Several of the RN'S I work with still put a 2x2 gauze over the biopatch and cover this with a tegaderm dressing. Anyone have any data on this practice? THe Biopatch rep is clueless. thanks
P.S. I'm new to this site

If you are using a Biopatch to prevent or ward off line infection, why then is a 2X2 placed over it, but under the TSM? You always want the best visualization of the IV site and covering it with a 2X2 prohibits that. As an IV nurse, I place a 2x2 over the insertion site, but only after I place a Midline or a PICC if I am accessing that vein with a 14 or 16g introducer and not using the MST procedure.

That then, becomes a 24 drsg. Meaning that after 24 hours do a sterile drsg change, but when redressing, omit the qauze. You see, the introducers to gain access into the vein (using traditional methods) create a large opening in the skin and it is likely to bleed the first 24 hours. Therefore, the need to get rid of the 2x2 24 hrs post insertion.

bobnurse · Aug 29, 2007

I know INS say's if there is gauze under a tegaderm dsg then it is a gauze dsg. Several of the RN'S I work with still put a 2x2 gauze over the biopatch and cover this with a tegaderm dressing. Anyone have any data on this practice? THe Biopatch rep is clueless. thanks
P.S. I'm new to this site

Gauze dressings have to be changed max every 48 hours. We sometimes place gauze over sites that are moist. This is rare though. This is both the cdc and ins standard.

I would find out exactly why they are placing the 2x2. If its a dry site, then its not necessary.

iluvivt, BSN, RN · Aug 31, 2007

i find that if nurses understand why they are doing something i get better compliance so here it is any cvc with a gauze dsg(with or without a biopatch) should be changed at 48 hrs ....studies show the use of gauze after 48 hrs promotes increased bacterial growth. usually a picc may ooze for 24-48 hrs post insertion especially those without a reverse taper design) so one uses the gauze to absorb the drainage...once oozing stops..switch to the use of a semi- permeable transparent dsg...no gauze under the dsg (ok to pad the tails as long as they are seperate from the tsm dsg) biopatch= a good thing 50-60% reductions in infections with their use (smooth side toward skin open radial slit wrap cath approximate edges)..policies vary about change times...we leave in place for 7 days as long as clean dry intact and without complications...remember that if a picc suddenly starts oozing after initial insertion-related drainage...it could be a symptom of thrombosis/////assess carefully hope this helps mary