Hi all

The uncertainty in all this is "a well healed cuff".  Most people think
it takes 4-6 weeks for a cuff to in grow.  But we don't really know. 
(We've taken cuffed catheters out months later and the tissue hadn't
ingrown, and others have in much less time.)

A "tug" test is really the only way to tell and I sure wouldn't
recommend that!

Nonetheless, I defer to clinicians who have used the strategies
discussed in terms of minimal dressings, etc.

Lots of us are working on other securement systems which will be more
consistent and predictable.  Hopefully we'll see better systems soon.

Gail

>>> "Lynn Hadaway" <[EMAIL PROTECTED]> 12/22/05 11:15 AM >>>
This can be done and is mentioned in the ONS guidelines. Just make 
sure the cuff inside the tunnel is well-healed and omit the dressing. 
Lynn

At 7:41 AM -0800 12/22/05, Bartholomew , Jerry A (SPO) wrote:
>         I have a young nurse as a patient who, after three PICC line 
>placements, now has a Hickman line.  We had requested an implanted 
>port, but they decided on the Hickman because she suffers from 
>chronic folliculitis.  She is extremely sensitive to everything. 
>Every type of hypoallergenic dressing has been tried, including the 
>IV3000, Sorbaview 2000, Duoderm, Hypafix tape, you name it.  We are 
>currently using the IV3000, which did well for the first three 
>weeks, but now the skin beneath it is becoming reddened, and burns 
>when cleaned with alcohol. 
>
>         Since this is a cuffed, tunneled line, I am wondering 
>whether or not it might be better in her case to leave the site open 
>to air.  She is an outpatient, so she's not around the constellation 
>of killer pathogens that inpatients face.  Has anyone else done this?
>
>
>
>Jerry Bartholomew RN BSN CRNI
>Vascular Access Specialist
>Veterans Affairs Medical Center
>Spokane, Washington


-- 
Lynn Hadaway, M.Ed., RNC, CRNI
Lynn Hadaway Associates, Inc.
126 Main Street, PO Box 10
Milner, GA 30257
http://www.hadawayassociates.com
office 770-358-7861

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