Improved long-term maintenance of central venous catheters with a new dressing technique.

Nursing procedures that may be important for maintaining in-dwelling central venous catheter sterility include the use of occlusive dressings, the frequency of dressing changes, the number and skill of nurses doing the dressing changes, the duration of catheterization, the use of antimicrobial ointment, and the extent to which sterile procedures are used during catheter placement. During a 9-month period, two different methods for applying central venous catheter dressings were compared. A new method designed to improve the stability of the dressing and to reduce tension on the catheter was found to be associated with longer maintenance of the dressings compared with a more traditional dressing; 14% fewer dressings were changed because of loss of occlusiveness. With this dressing technique and a strict protocol, including insertion and maintenance of central venous catheters by a nutritional support team, prolonged (greater than 7 days) maintenance of central venous catheters was found to be possible without an increase in the incidence of infection.