Issue: December 2015
October 28, 2015
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Chlorhexidine catheter gel dressing reduces microorganisms at insertion, suture sites

Issue: December 2015
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A catheter dressing incorporating a chlorhexidine gluconate gel pad may reduce the presence of microorganisms at insertion and suture sites, according to recently published data.

“The use of [central venous catheters (CVCs)] is still associated with a relatively large number of infections, resulting in increased patient morbidity, mortality and health care costs,” the researchers wrote. “Short term CVCs may become colonized via migration of microorganisms from the CVC insertion site down the external catheter surface, during manipulation of catheter hubs, hematogenous seeding from another site of infection or contaminated infusates. To prevent microbial contamination of a CVC from the skin at the CVC insertion site, appropriate skin antisepsis is of paramount importance.”

Researchers examined the antimicrobial qualities of a transparent film dressing made with a chlorhexidine gluconate (CHG) gel for use with CVCs. From January 2013 to October 2014, 273 adult patients admitted to a large university hospital’s critical care unit requiring a CVC were enrolled for study. Approximately half of the study population received the interventional CHG dressing, with others remaining on standard nonantimicrobial dressing. Samples from the CVC insertion site, CVC-securing suture site, sutures and segments of the CVC were taken upon catheter removal and tested for the primary outcome of microorganism frequency. CHG susceptibility among isolated samples also was examined.

While both study groups had comparable microbial loads on control swabs, there was a reduction in microorganisms recovered from all sites among the intervention group (P < .001). Researchers observed no differences in microbial susceptibility to CHG in either group, and no severe adverse events were reported.

“The CHG gel containing IV dressing reduced microbial numbers on the skin at the CVC insertion site, suture puncture sites and CVC-securing sutures of critical care patients compared with a standard dressing,” the researchers wrote. “Because of the close proximity of the sutures to the catheter insertion site and high risk of contamination, exploration of alternative CVC securement methods is warranted.” – by Dave Muoio

Disclosure: Karpanen reports receipt of honoraria to present and attend an international conference supported by 3M, developer of the CHG dressing examined in the study. Please see the full study for a list of all other authors’ relevant financial disclosures.