Less frequent catheter dressing changes decrease local cutaneous toxicity of high-dose chemotherapy in children, without increasing the rate of catheter-related infections: results of a randomised trial
- 1 April 2002
- journal article
- clinical trial
- Published by Springer Science and Business Media LLC in Bone Marrow Transplantation
- Vol. 29 (8), 653-658
- https://doi.org/10.1038/sj.bmt.1703511
Abstract
Cutaneous lesions caused by catheter dressing changes can be serious and generate local pain in children undergoing high-dose chemotherapy followed by bone marrow transplantation. One hundred and thirteen children entered a randomised trial to compare two catheter dressing change frequencies (15 days vs 4 days). Skin toxicity was classified according to the following scale: grade 0: healthy skin, to grade 4: severe skin toxicity. A qualitative culture of the skin at the catheter entry site was taken whenever the dressing was changed. Of the 112 evaluable children (56 in each group) 32 developed grade 2 local skin toxicity (eight in the 15-day group and 24 in the 4-day group; P = 0.001). Although higher in the 4-day group, the proportions of children experiencing pain during and between dressing changes were not statistically different between the two groups. The proportion of patients with one or more positive skin culture(s) at the catheter entry site during hospitalisation were similar in the two groups (27% in the 15-day group and 23% in the 4-day group) as were the proportions of documented nosocomial bloodstream infections (11% and 13%; NS). Whereas the planned frequency was maintained in the 4-day group (mean = 4 days, s.d. = 1), it was usually shortened in the 15-day group (mean = 8 days, s.d. = 4), mainly because dressings had loosened. Decreasing the catheter dressing change frequency proved efficient in reducing cutaneous toxicity without increasing the risk of local and systemic infection. In our unit, catheter dressings are changed every 8 days since this analysis.Keywords
This publication has 13 references indexed in Scilit:
- Increased Incidence of Central Venous Catheter-Related Infections in Bone Marrow Transplant PatientsAmerican Journal of Clinical Oncology, 1995
- A prospective, randomized trial of gauze and two polyurethane dressings for site care of pulmonary artery catheters: Implications for catheter managementCritical Care Medicine, 1994
- Lack of Clinical Benefit from Subcutaneous Tunnel Insertion of Central Venous Catheters in Immunocompromised PatientsClinical Infectious Diseases, 1994
- Skin versus hub cultures to predict colonization and infection of central venous catheter in intensive care patientsInfection, 1994
- Pathogenesis of infections related to intravascular catheterizationClinical Microbiology Reviews, 1993
- Evaluation of Dressing Regimens for Prevention of Infection With Peripheral Intravenous CathetersPublished by American Medical Association (AMA) ,1987
- PREDICTIVE VALUE OF SURVEILLANCE SKIN CULTURES IN TOTAL-PARENTERAL-NUTRITION-RELATED INFECTIONThe Lancet, 1982
- Estimation of confidence limits for the cumulative probability of survival in life table analysisJournal of Chronic Diseases, 1978
- Asymptotically Efficient Rank Invariant Test ProceduresJournal of the Royal Statistical Society. Series A (General), 1972
- Nonparametric Estimation from Incomplete ObservationsJournal of the American Statistical Association, 1958