On a tunneled catheter, these sutures usually remain in place for
10 days to 2 weeks. The total time for proper ingrowth of the subq
tissue to the cuff could be several weeks, depending upon her body's
response. Leaving a dressing off should only be done after the tissue
has grown in to the cuff. Those sutures will be gone by then. It
sounds like this catheter has not had enough time for ingrowth yet. Is
this the only site where she has folliculitis? If so, this can be
caused by antiseptic solutions and placing the dressing on before
these solutions have had time to thoroughly dry. I would discuss with
her physician about the removal of the sutures and the ingrowth before
leaving a dressing off in this case. I guess I thought your original
message was about a longer dwelling tunneled catheter. Are you using a
skin protectant solution? This is a critical step to maintain skin
integrity under all catheter dressings. 3M has one that does not
sting. Lynn
At 8:23 AM -0800 12/22/05, Bartholomew , Jerry A \(SPO\)
wrote:
She also has a couple of sutures which loosely secure the hub. Would you recommend leaving them exposed, or removing them and having her tuck the hub into her bra?
Jerry Bartholomew RN BSN CRNI
Vascular Access Specialist
Veterans Affairs Medical Center
Spokane, Washington
From: Lynn Hadaway [mailto:[EMAIL PROTECTED]
Sent: Thursday, December 22, 2005 8:15 AM
To: Bartholomew , Jerry A (SPO); [EMAIL PROTECTED]
Subject: Re: Hickman line and skin sensitivity
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
--
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
Lynn Hadaway Associates, Inc.
126 Main Street, PO Box 10
Milner, GA 30257
http://www.hadawayassociates.com
office 770-358-7861
