There have been some studies to document the fact that markers of
inflammation are not caused by the catheter material, both
polyurethane and silicone. So I would not think that the catheter
material is the problem. However, there could be stimulation of mast
cells by the physical presence of the catheter, both materials. When
mast cells degranulate, they release histamine and heparin plus other
factors are metabolized on the mast cell wall through lipid
synthesis. These factors are responsible for extending the signs and
symptoms. I have seen the problem of site redness in a circular
pattern around the puncture site; it never improves or gets worse.
The difference between what I am describing and the original question
is that there has never been any drainage from what I have seen. In
the original question, there was drainage that apparently responded
to a Biopatch. So I would think this to be an infectious process, and
not a simple immune respond to the presence of the catheter. Lynn
At 2:30 PM -0700 5/15/06, Dianne Sim wrote:
From: Dianne Sim [mailto:[EMAIL PROTECTED]
Sent: Monday, May 15, 2006 2:25 PM
To: 'Anna Liang'
Subject: RE: picc site redness
Just as some folks develop keloid tissue more than others, I think that some
patient's insertion sites respond to the mechanical irritation of the
catheter in situ and/or the catheter composition, in varying degrees. The
trick is to know what is considered normal and what is not. In the
institutions I had worked at, "normal" errythema was thought to be anything
smaller than 1cm diameter across the site. Of course, if you pick up any
other signs or symptoms in your assessment, such as swelling, induration,
exudate, pain, palpable cord it could change your diagnosis. In this case, I
would probably have the staff continue observation of the site qShift and
only respond if the errythema increases past 1cm or has other S&S.
Regards
Dianne Sim RN
CEO & President
IV Assist, Inc.,
2675 Appian Way
Pinole, CA 94564
Phone: (510) 222-8403
Fax: (510) 222-8277
Email: [EMAIL PROTECTED]
Confidentiality Notice: This e-mail and any attachments are intended only
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-----Original Message-----
From: [EMAIL PROTECTED] [mailto:[EMAIL PROTECTED]
On Behalf Of Anna Liang
Sent: Monday, May 15, 2006 7:00 AM
To: [EMAIL PROTECTED]; [EMAIL PROTECTED]
Subject: picc site redness
would like to know your practice regarding dealing
with site redness.
one kid has a picc, last week there was some drainage
on the site, and the site is red -- the biopatch was a
bit swelled up. in order to assess the site, the
dressing was changed every 2-3 days with biopatch.
there is no more drainage. but the site is still red
(0.5cm X 0.5cm).
should I consider pulling the picc if the redness does
not improve?
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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
