Good day all,
I am finding CVAD dressings that are placed on top of duoderm instead of the skin. I am told the duoderm is for skin protection. There are conflicting stories about the dressing change process. Some staff members are charting they do not remove the duoderm but rather change the dressing only. Some people care charting they change the duoderm, but documentation is not consistent.
I am looking for other ways to protect the skin and what can we use to anchor our piccs to the skin without damage to the tissue. Will dressing integrity be compromised since the dressing is not on the tissue? Are there products that we should evaluate that can help? We use sorbaview in our current dressing packs, but we also have tegaderm and telfa at our disposal too. Looking forward to all replies and thanks for this great forum.
I have only seen Duoderm used around a CVAD when there is a serious skin problem and the dressing can not be in direct contact with this skin. The Duoderm is cut large enough to surround the area but not be in contact with the damaged skin. Standardization is the goal for any hospital. Plus the Duoderm increases the costs when it is probably not necessary. To promote skin integrity with the very first dressing on any VAD, peripheral and central, I would always use and strongly recommend use of a skin protectant solution. Many companies now make these solutions in small pads like an alcohol pad or on swabsticks. This solution puts a barrier between the skin and the dressing, protects the skin and increases adherence of the dressing. The only issue is not to put this solution under the CHG pad or gel dressing as this protectant solution will block the CHG from reaching the puncture site. But it can and should be used where the remainder of the dressing touches the skin. Adhesive remover pads may be beneficial to remove dressings and stabilization devices. Many brands of stablization devices are now available including those that use adhesive footprints on the skin and the one deployed subcutaneously. 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
Thanks for your reply Lynn. I find the duoderm is under the entire dressing with a small hole for the insertion area, whether it is a mediport or PICC. I also find they do not always change the duoderm with each dressing change. Again, thanks for your input Lynn.