Effect of an acrylic terpolymer barrier film beneath transparent catheter dressings on skin integrity, risk of dressing disruption, catheter colonisation and infection

Pivkina, A.I.; Gusarov, V.G.; Blot, Stijn; Zhivotneva, I.V.; Pasko, Nevi; Zamyatin, M.N.

doi:10.1016/j.iccn.2017.11.002

Cited by 13 publications

(18 citation statements)

References 40 publications

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“…The selected studies included 18 RCTs 19-36 and 2 quasi-experimental studies, 37,38 and all of them were performed in hospital settings. Furthermore, 6 studies were multicentric (≥ 2 hospitals), [19][20][21][22][23]27 14 studies were performed on adults, [20][21][22][23][24][25][27][28][29]31,[33][34][35]38 and 6 studies examined neonates or pediatric populations. 19,26,30,32,36,37 Of the studies with this information, 13 included ICU patients, 19,[21][22][23][24][25][26]29,32,[34][35][36][37] 4 included onco-hematological patients, 27,30,31,33 and 1 included non-ICU patients.…”

Section: Resultsmentioning

confidence: 99%

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Effectiveness of chlorhexidine dressings to prevent catheter-related bloodstream infections. Does one size fit all? A systematic literature review and meta-analysis

Puig-Asensio

Marra

Childs

et al. 2020

Infect. Control Hosp. Epidemiol.

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Objective: To evaluate the effectiveness of chlorhexidine (CHG) dressings to prevent catheter-related bloodstream infections (CRBSIs). Design: Systematic review and meta-analysis. Methods: We searched PubMed, CINAHL, EMBASE, and ClinicalTrials.gov for studies (randomized controlled and quasi-experimental trials) with the following criteria: patients with short- or long-term catheters; CHG dressings were used in the intervention group and nonantimicrobial dressings in the control group; CRBSI was an outcome. Random-effects models were used to obtain pooled risk ratios (pRRs). Heterogeneity was evaluated using the I2 test and the Cochran Q statistic. Results: In total, 20 studies (18 randomized controlled trials; 15,590 catheters) without evidence of publication bias and mainly performed in intensive care units (ICUs) were included. CHG dressings significantly reduced CRBSIs (pRR, 0.71; 95% CI, 0.58–0.87), independent of the CHG dressing type used. Benefits were limited to adults with short-term central venous catheters (CVCs), including onco-hematological patients. For long-term CVCs, CHG dressings decreased exit-site/tunnel infections (pRR, 0.37; 95% CI, 0.22–0.64). Contact dermatitis was associated with CHG dressing use (pRR, 5.16; 95% CI, 2.09–12.70); especially in neonates and pediatric populations in whom severe reactions occurred. Also, 2 studies evaluated and did not find CHG-acquired resistance. Conclusions: CHG dressings prevent CRBSIs in adults with short-term CVCs, including patients with an onco-hematological disease. CHG dressings might reduce exit-site and tunnel infections in long-term CVCs. In neonates and pediatric populations, proof of CHG dressing effectiveness is lacking and there is an increased risk of serious adverse events. Future studies should investigate CHG effectiveness in non-ICU settings and monitor for CHG resistance.

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Section: Resultsmentioning

confidence: 99%

“…28 The definition of CRBSI, exit-site and tunnel infections, and adverse events varied across the studies (Appendix 4 online). Also, 5 studies reported CRBSI rates ≥ 2.0 per 1,000 catheter days 21,25,27,30,35 in at least one study group and 2 studies reported CRBSI rates <1.5 per 1,000 catheter days in both groups. 22,23…”

Section: Resultsmentioning

confidence: 99%

Effectiveness of chlorhexidine dressings to prevent catheter-related bloodstream infections. Does one size fit all? A systematic literature review and meta-analysis

Puig-Asensio

Marra

Childs

et al. 2020

Infect. Control Hosp. Epidemiol.

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“…3A. Twenty-five RCTs [19,20,22,23,31–41,44–47,53,54–58] (7090 patients) reported the incidence of CRBSI and included all 10 dressings (CHG, BDD, AD, TD, SPU, SDG, SAD, OD, NTD, and HD). The result indicated that TD (odds ratio [OR] 0.35, 95% CrI 0.14, 0.89) was statistically significantly more effective than the other dressings in preventing CRBSI.…”

Section: Resultsmentioning

confidence: 99%

“…Ten RCTs [19,20,31,39–41,43,49,54,51] (1497 participants) reported the CRBSI rate per 1000 catheter-days. Suture + BPU (OR 0.34, 95% CrI 0.27, 0.43) was statistically significantly more effective than dressings alone in reducing the CRBSI rate per 1000 catheter-days.…”

Section: Resultsmentioning

confidence: 99%

Comparative efficacy of 13 antimicrobial dressings and different securement devices in reducing catheter-related bloodstream infections

Dang¹,

Li²,

Tian³

2019

Medicine

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Purpose: The purpose of our study is to carry out a Bayesian network meta-analysis comparing the efficacy of different antimicrobial dressings for prevention of catheter-related blood infections (CRBSI) and rank these antimicrobial dressings for practical consideration. Methods: We searched the PubMed, Cochrane library, Embase, earlier relevant meta-analysis and reference lists of included studies for randomized controlled trials (RCTs) that compared dressings for prevention of CRBSI. Two authors independently extracted data from each included RCT according to a predesigned Excel spreadsheet and assessed the methodological quality of included RCTs using the Cochrane risk of bias tool. Data was analyzed using the WinBUGS (V.1.4.3) and the Stata (V.15.0). Results: Finally, 35 RCTs involving 8494 patients and evaluating 13 dressings were included. Network meta-analysis showed that transparent dressing may be the best way to prevent CRBSI. Suture and bordered polyurethane dressing might have the lowest risk of CRBSI rate per 1000 catheter-days, and sutureless securement device might lead to the lowest incidence of catheter failure. Conclusions: This network meta-analysis indicated that transparent dressings may be selected for the prevention of CRBSI in patients with central venous catheters, which is of importance in future research. Although evidence is scant, more attention should be paid to head-to-head comparisons of the most commonly used dressings in this field.

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“…However, the effect on CR-BSI was not demonstrated and this technology was tested only in CHG impregnated dressing. 91 Both CHG impregnated sponges and CHG-gel dressings were associated with a 60% decrease in the risk of catheter infections including CR-BSIs. 90,92 However, CHG-impregnated sponges and CHG-gel dressings triggered contact dermatitis at a rate of <10/10,000 catheters in adult patients.…”

Section: Dressingmentioning

confidence: 97%

Management and Prevention of Central Venous Catheter-Related Infections in the ICU

Buetti

Timsit

2019

Semin Respir Crit Care Med

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Central venous catheter-related bloodstream infections (CR-BSI) are a frequent event in the intensive care unit (ICU) setting. In contrast to other nosocomial infections, most risk factors for CR-BSI are linked to the device and can be prevented efficiently. Rates of CR-BSI higher than 1 per 1,000 catheter days are no longer acceptable. A continuous quality improvement program is effective to reduce them. Key elements of prevention of CR-BSI are hand hygiene, avoidance of insertion of unnecessary catheters, full sterile barrier precautions at insertion, preferential use of subclavian venous insertion site, cutaneous antisepsis with 2% chlorhexidine alcoholic preparation, use of chlorhexidine-impregnated dressings, immediate replacement of moistened or detached catheter dressings, and removal of catheters as soon as possible. Audit and feedback of the process of care, infection rates, and periodic re-education of health care providers are other instrumental tools in the prevention of CR-BSI. Catheter removal is the main therapeutic intervention, especially recommended in the case of sepsis or shock. While awaiting culture results, an empiric antimicrobial treatment of CR-BSI should target gram-positive microorganism (i.e., Staphylococcus aureus) and gram-negative coverage should be based on clinical variables, patients' risk factors, and previous colonization status. While a short course of antimicrobials (7 days) is sufficient for noncomplicated CR-BSI, a longer course of 14 days should be preferred for uncomplicated S. aureus and Candida CR-BSI. In case of persisting fever or positive blood culture after 3 days despite adequate antimicrobial therapy and catheter removal, catheter-related complications (e.g., endocarditis, thrombophlebitis, septic metastasis) should be ruled out.

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Effect of an acrylic terpolymer barrier film beneath transparent catheter dressings on skin integrity, risk of dressing disruption, catheter colonisation and infection

Cited by 13 publications

References 40 publications

Effectiveness of chlorhexidine dressings to prevent catheter-related bloodstream infections. Does one size fit all? A systematic literature review and meta-analysis

Effectiveness of chlorhexidine dressings to prevent catheter-related bloodstream infections. Does one size fit all? A systematic literature review and meta-analysis

Comparative efficacy of 13 antimicrobial dressings and different securement devices in reducing catheter-related bloodstream infections

Management and Prevention of Central Venous Catheter-Related Infections in the ICU

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