TITLE:
Local Cutaneous Effects Associated with Chlorhexidine-Impregnated Gel Dressing in Hematopoietic Stem Cell Transplantation Patients
AUTHORS:
Bruna Nogueira dos Santos, Maria Carolina de Oliveira, Fernanda T. M. M. Braga, Amanda Salles Margatho, Laís C. C. Esparrachiari, Renata C. de C. P. Silveira
KEYWORDS:
Bandages, Catheterization, Central Venous Catheters, Hematopoietic Stem Cell Transplantation, Skin Abnormalities
JOURNAL NAME:
Open Journal of Nursing,
Vol.8 No.2,
February
13,
2018
ABSTRACT: Introduction: Hematopoietic stem cell transplantation (HSCT) often requires a central
venous catheter (CVC) for quick and safe vascular access. Currently, new
technologies are available to protect the catheter insertion site, such as
chlorhexidine-impregnated gel dressings (CIGD). Objectives: To evaluate
local cutaneous effects associated with CIGD in patients undergoing HSCT. Methods: In this cross-sectional, prospective study, we evaluated 25 HSCT patients who
had a CVC inserted. Patients were visited daily to monitor the CIGD changing
procedures and evaluate abnormalities of the underlying skin after dressing
removal. Findings: Local erythema was the most frequently detected
abnormality, although usually transient and considered secondary to the
mechanical trauma of dressing removal. The most severe lesions, consisting of
areas of skin loss, erythematous plaques and/or vesicles were classified as
skin irritation and presented in 11 (44%) of the 25 patients. An association
test showed that skin irritation was more frequent in patients who underwent
allogeneic HSCT (p = 0.03). Skin irritation was most frequently observed in
areas of contact with the non-woven polyester adhesive tape (n = 22; 88%),
which made up the adhesive margins of the dressing. The CIGD was discontinued
in 6 (54%) of the 11 patients who presented severe skin injuries. Conclusion: In this study, we detected that skin irritation was more frequent in patients
who underwent allogeneic HSCT. The most common skin manifestation was skin
loss.