Renata Cristina de Campos Pereira Silveira1, Paula Elaine Diniz Dos Reis2, Elaine Barros Ferreira2, Fernanda Titareli Merizio Martins Braga3, Cristina Maria Galvão3, Alexander Michael Clark4. 1. General and Specialized Nursing Department, Ribeirão Preto College of Nursing, WHO Collaborating Centre for Nursing Research Development, University of São Paulo, Bandeirantes Avenue, 3900. Campus - Monte Alegre, Ribeirão Preto, SP, 14040-902, Brazil. recris@eerp.usp.br. 2. Nursing Department, School of Health Sciences, University of Brasília, University Campus - Darcy Ribeiro b.b - Asa Norte, Brasília, DF, 70910-900, Brazil. 3. General and Specialized Nursing Department, Ribeirão Preto College of Nursing, WHO Collaborating Centre for Nursing Research Development, University of São Paulo, Bandeirantes Avenue, 3900. Campus - Monte Alegre, Ribeirão Preto, SP, 14040-902, Brazil. 4. University of Alberta, 116 St & 85 Ave, Edmonton, AB, T6G 2R3, Canada.
Abstract
PURPOSE: To identify the most effective dressing for covering long-term central venous catheter exit site to prevent catheter-related infections and skin irritation in patients undergoing hematopoietic stem cell transplantation. METHODS: Systematic Review. The search was performed in the following electronic databases: CINAHL, Cochrane Library CENTRAL, EMBASE, LILACS, PubMed, Scopus, and Web of Science. Google Scholar was used for the gray literature search. RESULTS: Seven studies were included which tested different arrangements of dressings: sterilized gauze and adhesive tape with a transparent polyurethane film (n = 2), transparent polyurethane film with a different replacement interval frequency (n = 2), transparent polyurethane film with and without chlorhexidine released continuously by the dressing at the site of intravascular catheter insertion (n = 2), and dressings vs. no dressings (n = 1). The meta-analysis for catheter-related infection prevention showed no difference between type of dressing (RR 1.76, [95% CI 0.82; 3.75], I2 0%) and for the replacement frequency at different intervals (RR 1.04, [95% CI 0.67; 1.61], I2 0%). The meta-analysis for skin irritation evaluated the transparent polyurethane film replacement frequency and indicated that a longer dressing replacement interval (10 to 15 days) reduces the risk of developing this outcome (RR 0.71, 0.52; 0.96, 95% CI, I2 24%). CONCLUSIONS: Regarding the type of the dressing, there is no evidence indicating the best dressing. Although there is no evidence available for the ideal replacement frequency, the risk to develop skin irritation is reduced in longer dressing replacements intervals.
PURPOSE: To identify the most effective dressing for covering long-term central venous catheter exit site to prevent catheter-related infections and skin irritation in patients undergoing hematopoietic stem cell transplantation. METHODS: Systematic Review. The search was performed in the following electronic databases: CINAHL, Cochrane Library CENTRAL, EMBASE, LILACS, PubMed, Scopus, and Web of Science. Google Scholar was used for the gray literature search. RESULTS: Seven studies were included which tested different arrangements of dressings: sterilized gauze and adhesive tape with a transparent polyurethane film (n = 2), transparent polyurethane film with a different replacement interval frequency (n = 2), transparent polyurethane film with and without chlorhexidine released continuously by the dressing at the site of intravascular catheter insertion (n = 2), and dressings vs. no dressings (n = 1). The meta-analysis for catheter-related infection prevention showed no difference between type of dressing (RR 1.76, [95% CI 0.82; 3.75], I2 0%) and for the replacement frequency at different intervals (RR 1.04, [95% CI 0.67; 1.61], I2 0%). The meta-analysis for skin irritation evaluated the transparent polyurethane film replacement frequency and indicated that a longer dressing replacement interval (10 to 15 days) reduces the risk of developing this outcome (RR 0.71, 0.52; 0.96, 95% CI, I2 24%). CONCLUSIONS: Regarding the type of the dressing, there is no evidence indicating the best dressing. Although there is no evidence available for the ideal replacement frequency, the risk to develop skin irritation is reduced in longer dressing replacements intervals.
Entities:
Keywords:
Bandages; Central venous catheter; Occlusive dressings; Systematic review
Authors: R Laura; M Degl'Innocenti; M Mocali; F Alberani; S Boschi; A Giraudi; M T Arnaud; R Zucchinali; M G Paris; R Dallara; S Thaler; G Perobelli; S Parfazi; T De Lazzer; G Peron Journal: Haematologica Date: 2000-03 Impact factor: 9.941
Authors: Boris Böll; Enrico Schalk; Dieter Buchheidt; Justin Hasenkamp; Michael Kiehl; Til Ramon Kiderlen; Matthias Kochanek; Michael Koldehoff; Philippe Kostrewa; Annika Y Claßen; Sibylle C Mellinghoff; Bernd Metzner; Olaf Penack; Markus Ruhnke; Maria J G T Vehreschild; Florian Weissinger; Hans-Heinrich Wolf; Meinolf Karthaus; Marcus Hentrich Journal: Ann Hematol Date: 2020-09-30 Impact factor: 3.673