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Are the surgeons using sterile wound closure strips instead of suture at the skin level? I can understand this to eliminate suture thus eliminates the risk of needlestick injury from sutures. I don't uderstand why you are saying that the dressing must be changed q48 hours. Is this a gauze and tape dressing? That is the only kind that requires 48 hour changes. If it is a transparent membrane, it can remain on for a week as long as it remains occlusive. When you remove the TSM dressing those sterile strips will come with it and you could displace the catheter itself because the subq cuff has no ingrowth of tissue yet. So I would say this is a challenge that you should discuss with your surgeons. The only thing I have seen in the literature that is special about dressing for a tunneled cuffed catheter is that after complete ingrowth of the cuff, the dressing can be left off if the physician agrees to this. I have not seen anything else about the situation you are describing. So you will have to find a way to work this out with the surgeons as you will need to clean that skin. Regardless of which skin antiseptic agent being used, you need to apply a scrubbing method to apply it. So if the dressing itself has not pulled off these strips, this cleaning certainly will. You also need to clean the skin under those strips so they do need to be removed for this procedure. Lynn