CHANGE OF CENTRAL VENOUS CATHETER DRESSINGS TWICE A WEEK IS SUPERIOR TO ONCE A WEEK IN PATIENTS WITH HEMATOLOGICAL MALIGNANCIES

Thirty-two consecutive patients with haematological disorders, in need of a permanent central venous catheter (CVC) were randomly allocated to have their CVC bandages (Tegaderm) changed once (OAW, n=20) or twic e (TAW n=19) a week. The two randomization arms were balanced in respe ct of age, sex and underlying disease. The exit site of the CVC was in spected daily through the transparent bandage and erythema was noted. If severe erythema occurred, daily wet gauze dressings were applied. S amples for bacterial cultures were taken from the exit site of the CVC at every change of bandages. There was no difference in complications leading to removal of the CVC between the two groups (7/20 OAW vs. 7/ 19 TAW) or in CVC survival-time (P=0.4). However, the OAW group had mo re positive CVC tip cultures (OAW 11/14 vs. TAW 2/9; P<0.05) and a ten dency to: (i) more extra dressings (P=0.08); (ii) more cultures from t he exit skin site showing high numbers of colony forming units (P=0.07 ); (iii) shorter time to first exit site infection (P=0.09); and (iv) more Gram-positive septicaemias (P=0.08). Both clinical and bacteriolo gical data in this study indicate that changing transparent polyuretha ne CVC bandages twice a week is superior to once a week.