N. I. Pirogov National Medical Surgical Center, Moscow, Russia.
Dept. of Internal Medicine, Ghent University, Ghent, Flanders, Belgium; Burns, Trauma and Critical Care Research Centre, The University of Queensland, Brisbane, Australia.
Intensive Crit Care Nurs. 2018 Jun;46:17-23. doi: 10.1016/j.iccn.2017.11.002. Epub 2018 Mar 23.
We assessed the effect of a skin-protective terpolymer barrier film around the catheter insertion site on frequency of dressing disruptions and skin integrity issues (hyperaemia, skin irritation, residues of adhesives and moisture under the dressing). Secondary outcomes included colonisation of the central venous catheter (CVC) and rates of central line-associated bloodstream infection.
A monocentric, open-label, randomised controlled trial was performed comparing a control group receiving standard transparent catheter dressings without the skin-protecting barrier film and an intervention group receiving a transparent chlorhexidine-impregnated dressing with use of the skin-protective acrylic terpolymer barrier film (3M™ Cavilon™ No - Sting Barrier Film, 3 M Health Care, St. Paul, MN, USA).
Sixty patients were enrolled and randomised in the study accounting for 60 central venous catheters and a total of 533 catheter days. Dressing disruptions occurred more frequently and at sooner time point in the control group. Skin integrity issues were significantly less observed in the intervention group. No differences in CVC colonisation or central line-associated bloodstream infection were observed.
The application of a barrier film creating a skin-protective polymer layer beneath transparent catheter dressings is associated with less dressing disruptions and skin integrity issues without altering the risk of infectious complications if used in combination with a chlorhexidine-impregnated catheter dressing.
我们评估了在导管插入部位周围使用皮肤保护型共聚体屏障膜对敷料脱落和皮肤完整性问题（充血、皮肤刺激、黏附剂残留和敷料下的潮气）的发生频率的影响。次要结局包括中心静脉导管（CVC）定植和导管相关性血流感染的发生率。
一项单中心、开放标签、随机对照试验，将接受无皮肤保护屏障膜的标准透明导管敷料的对照组与接受含有皮肤保护型丙烯酸共聚体屏障膜（3M™ Cavilon™ No-Sting 屏障膜，3M 医疗保健，明尼苏达州圣保罗）的透明洗必泰浸渍敷料的干预组进行比较。
研究共纳入 60 例患者，随机分配到对照组（60 个中心静脉导管，共 533 个导管日）和干预组。对照组的敷料脱落更频繁，且更早发生。干预组皮肤完整性问题明显较少。CVC 定植或导管相关性血流感染无差异。
在透明导管敷料下应用形成皮肤保护聚合物层的屏障膜可减少敷料脱落和皮肤完整性问题，但与使用洗必泰浸渍导管敷料联合使用时，并不会改变感染性并发症的风险。
