We have been using the CHG tegaderm instead of biopatch and have been seeing insertion sites that are pinkish/red and some are inflamed. We use the Arrow Chlorgard (CHG impregnated) PICC. We have been making sure to give the skin plenty of time to dry before applying the dressing. They do not have signs of infection and so we are wondering if it is just too much CHG. Wondering if other people have seen this as well.
Are you also using alcoholic CHG for skin prep, plus CHG dressing and CHG catheter? Does the red area confirm in size and shape to the prepped area, the area of the CHG gel, the entire dressing, or none of those? You may be right that these patients simply can not tolerate exposure to this much CHG. Anything in common with these patients - diagnosis or other allergies? 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
Hi Lynn. Thanks for replying! Yes the dressing change kit has CHG scubber along with the CHG dressing and the CHG catheter. They also get daily CHG baths due to CLABSI rate of 1.62 per 1000 catheter days. The red area is usually just around the insertion site almost dime sized. There is no common dx or allergies that we have found. We are thinking of using Biopatch w/ a plain tegaderm on 1/2 of our patients and CHG tegaderm on the others. We have been switching patients to the biopatch when we see this and the skin does improve. We are wondering if anyone else has seen this.
In the past, long before CHG use, I have seen this small area of pink/red circle around a puncture site. Never gets worse or better but remains the same during the dwell of the catheter. But now that there is so much CHG, who knows what it actually is? Have you contacted 3M about this for any information on their gel dressing? 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