Chlorhexidine and gauze and tape dressings for central venous catheters: a randomized clinical trial

Pedrolo, Edivane; Danski, Mitzy Tannia Reichembach; Vayego, Stela Adami

doi:10.1590/0104-1169.3443.2478

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Revista Latino-Americana de Enfermagem

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Original Articles • Rev. Latino-Am. Enfermagem 22 (5) • Sep-Oct 2014 • https://doi.org/10.1590/0104-1169.3443.2478 copy

Chlorhexidine and gauze and tape dressings for central venous catheters: a randomized clinical trial¹ 1 Paper extracted from master's thesis "Chlorhexidine dressing for central venous catheters: a randomized clinical trial" presented to Universidade Federal do Paraná, Curitiba, PR, Brazil

Authorship SCIMAGO INSTITUTIONS RANKINGS

OBJECTIVE:

to assess the effectiveness of the chlorhexidine antimicrobial dressing in comparison to the gauze and tape dressing in the use of central venous catheters.

METHOD:

a randomized clinical trial was conducted in the intensive care and adult semi intensive care units of a university hospital in the south of Brazil. The subjects were patients using short-term central venous catheters, randomly assigned to the intervention (chlorhexidine antimicrobial dressing) or control (gauze and micro porous tape) groups.

RESULTS:

a total of 85 patients were included: 43 in the intervention group and 42 in the control group. No statistically significant differences were found between dressings in regard to the occurrence of: primary bloodstream infections (p-value = 0.5170); local reactions to the dressing (p-value = 0.3774); and dressing fixation (p-value = 0.2739).

CONCLUSION:

both technologies are effective in covering central venous catheters in regard to the investigated variables and can be used for this purpose. Registry ECR: RBR-7b5ycz.

Clinical Trial; Chlorhexidine; Catheterization, Central Venous; Technology; Nursing; Bandages

Variable		Chlorhexidine Intervention group (n=43)		Control group dressing (n=42)		p-value
Variable		n	%	n	%	p-value
Sex						0.5379*
	Female	19	44.2	18	42.9
	Male	24	55.8	24	57.1
Ethnicity						0.1663*
	Caucasian	36	83.7	39	92.9
	African-descendant	7	16.3	3	7.1
Primary focus of pathology						0.2669^†
	Digestive system	18	41.9	9	21.4
	Nervous system	10	23.2	11	26.2
	Malignant neoplasia	7	16.3	7	16.7
	Circulatory system	2	4.6	5	11.9
	Other	6	14.0	10	23.8
Comorbidities						0.2683^†
	One	5	11.6	12	28.6
	Two	13	30.2	8	19.1
	Three	5	11.6	4	9.5
	Four or more	2	4.7	4	9.5
	No comorbidities	18	41.9	14	33.3
Hospitalization unit						0.2298*
	Intensive Care Unit	40	93.0	36	85.7
	Semi-intensive care unit	3	7.0	6	14.3
Discharge or death						0.3784*
	Discharge	27	62.8	24	57.1
	Death	16	37.2	18	42.9
Antimicrobial before puncture						0.5152^†
	One antimicrobial	6	14.0	10	23.8
	Two antimicrobial	9	20.9	8	19.1
	Three or more antimicrobial	3	7.0	5	11.9
	No	25	58.1	19	45.2

Variable		Chlorhexidine Intervention group (n=43)		Control group dressing (n=42)		p-value
Variable		n	%	n	%	p-value
Indication						0.8053*
	Administration of vasoactive drugs	38	88.4	37	88.1
	Monitoring	4	9.3	3	7.1
	Total parenteral nutrition	1	2.3	2	4.8
Unit where puncture was performed						0.9654*
	Clinical	1	2.3	1	2.4
	Surgical center	17	39.6	17	40.5
	Semi-intensive care unit	5	11.6	7	16.7
	Intensive care unit	16	37.2	13	30.9
	Emergency room	4	9.3	4	9.5
Number of lumen catheter						0.6156^†
	One	5	11.6	5	11.9
	Two	38	88.4	37	88.1
Anatomical site of catheter insertion						0.2948^†
	Subclavian	31	72.1	27	64.3
	Jugular	12	27.9	15	35.7
Reason follow-up ceased						0.9678*
	Catheter removal	25	58.2	23	54.8
	Death	11	25.6	11	26.2
	Placement of a second catheter	5	11.6	5	11.9
	Non-infectious diseases	2	4.6	3	7.1

Variable		Chlorhexidine Intervention group (n=43)		Control group dressing (n=42)		p-value
Variable		n	%	n	%	p-value
Primary bloodstream infection		6	13.95	5	11.90	0.5170*
Local reaction to dressing		17	39.53	19	45.24	0.3774*
Signs and symptoms of local reaction
	Hyperemia	9	20.93	9	21.43	0.5824*
	Maceration	10	23.26	12	28.57	0.3777*
	Desquamation	4	9.30	2	4.76	0.3493*
	Itching	3	6.98	3	7.14	0.6507*
Fixation						0.2739*
	Good	36	83.72	38	90.48
	Poor	7	16.28	4	9.52

Escola de Enfermagem de Ribeirão Preto / Universidade de São Paulo Av. Bandeirantes, 3900, 14040-902 Ribeirão Preto SP Brazil, Tel.: +55 (16) 3315-3451 / 3315-4407 - Ribeirão Preto - SP - Brazil
E-mail: rlae@eerp.usp.br

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[1] Corresponding Author: Edivane Pedrolo Av. João Negrão, 1285 Bairro: Rebouças CEP: 80230-150, Curitiba, PR, Brasil E-mail: edivanepedrolo@gmail.com

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Chlorhexidine and gauze and tape dressings for central venous catheters: a randomized clinical trial1 1 Paper extracted from master's thesis "Chlorhexidine dressing for central venous catheters: a randomized clinical trial" presented to Universidade Federal do Paraná, Curitiba, PR, Brazil

OBJECTIVE:

METHOD:

RESULTS:

CONCLUSION:

Chlorhexidine and gauze and tape dressings for central venous catheters: a randomized clinical trial¹ 1 Paper extracted from master's thesis "Chlorhexidine dressing for central venous catheters: a randomized clinical trial" presented to Universidade Federal do Paraná, Curitiba, PR, Brazil