My grandson is TPN dependent recently having to return to TPN after failure of the gut following surgical resection. First we started back with central line which after 3 weeks he pulled out. We realized the 3mm tacaderm was adding to his discomfort. We have switch to sorbaveiw with benidine solution for drgs changes and a port was placed. His complaints and picking at the drgs decreased. Now we are dealing with heavy diaphoress at night we loose the drgs nightly. His poor skin is breaking down due to repeated changes let alone increased risk of infection. He is using a bio patch but many nights it too does not remain in place. Children's VAT RN in Chicago has suggested mastisol to increase adhesive quality. I have used Allicare skin prep which did not improve adhesive quality. In fact it just caused my glove to get sticking making drgs placement more difficult.
Pin the words of my beloved grandson " won't you please please help help meeee"
Laura brook RN MCM
There are numerous brands of skin protection solutions on the market. 3M makes a great one without alcohol and it does not burn when applied. This solution is applied where the adhesive dressing is touching his skin to protect the skin and make the dressing more adherent. With an implanted port and this problem, you also have to be greatly concerned about dislodgment of the port needle producing an extravasation injury. Lynn
Lynn Hadaway, M.Ed., RN, BC, CRNI
Lynn Hadaway Associates, Inc.
126 Main Street, PO Box 10
Milner, GA 30257
Website http://www.hadawayassociates.com
Office Phone 770-358-7861
One trick that our IV team has used seems to help keep dressings on a little bit better. After you have used the skin protectant and the dressing is applied, take the skin protectant pad and go over the dressing/skin connection. This helps to seal the dressing a little bit more and may help to keep those dressings on longer.
Good luck!
Janine Pritchett, RN-BC, BSN, VA-BC
Clinical Educator - Vascular Access
Try using 3M's Cavilon No Sting Barrier Film.