Evaluation of dressing regimens for prevention of infection with peripheral intravenous catheters. Gauze, a transparent polyurethane dressing, and an iodophor-transparent dressing

JAMA. 1987 Nov 6;258(17):2396-403.

Abstract

Four dressing regimens for peripheral venous catheters were studied in a prospective randomized clinical trial with 2088 Teflon catheters: (1) sterile gauze, replaced every other day, and three dressings left on for the lifetime of the catheter; (2) gauze; (3) a transparent polyurethane dressing; and (4) an iodophor-transparent dressing. The four dressings provided comparable coverage, except moisture accumulated more frequently under the transparent dressings (26% to 28% vs 20% to 21%). Cutaneous colonization under the dressing was low level and comparable with all four dressings (range, 10(0.58) to 10(0.70) colony-forming units). The rate of local catheter-related infection (greater than or equal to 15 colony-forming units) was also low and did not differ significantly (range, 4.6% to 5.9%); no catheter caused bacteremia. Stepwise logistic multivariate analysis showed cutaneous colonization of the insertion site (relative risk [RR] of infection, 3.86), contamination of the catheter hub (RR, 3.78), moisture under the dressing (RR, 2.48), and prolonged catheterization (RR, 1.75) to be significant risk factors for catheter-related infection. These data indicate that it is not cost-effective to redress peripheral venous catheters at periodic intervals; for most patients, either sterile gauze or a transparent dressing can be used and left on until the catheter is removed.

Publication types

  • Clinical Trial
  • Comparative Study
  • Randomized Controlled Trial
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Bandages*
  • Catheterization, Peripheral / adverse effects*
  • Catheters, Indwelling / adverse effects
  • Clinical Trials as Topic
  • Equipment Contamination
  • Evaluation Studies as Topic
  • Female
  • Humans
  • Infection Control*
  • Iodophors
  • Male
  • Middle Aged
  • Phlebitis / prevention & control
  • Polyurethanes
  • Prospective Studies
  • Random Allocation
  • Risk Factors
  • Sepsis / prevention & control

Substances

  • Iodophors
  • Polyurethanes