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If the dressing is soiled with blood or there is wetness under the dressing it will need to be changed as this increases the risk of infection Wrap a piece of occlusive dressing (e.g IV 3000) around the break, to ensure the line does not get dirty The company searched the Medicines and Healthcare Products Regulatory Agency (MHRA), Food and Drug Administration (FDA) and Manufacturer and User Facility Device Experience (MAUDE) systems to identify surveillance reports relating to Tegaderm CHG, between 7 January 2000 and 29 July 2013. This revealed 1 result from the MHRA and 109 results from MAUDE. The company also searched its post‑marketing surveillance data for reported skin reactions. This identified a marked reduction in reports, both in numbers and relative to increasing sales, after a modification to the dressing design in 2011 to incorporate a breathable film.
Using Tegaderm CHG instead of a standard dressing does not need any special additional training. At the topic selection phase, the Committee received expert advice that confirmed that minimal additional training would be needed. The Cheyne Child Development Service - School age Autism (ASD) Assessment Pathway Parent Information Krauss EM, Lalonde DH. Secondary healing of fingertip amputations: a review. Hand 2014;9(3):282–288. Timsit et al. (2012) reported a large multicentre randomised controlled trial, based in 12 intensive care units in France, involving 1,879 patients and 4,163 intravascular catheters (2,201 arterial and 1,962 central venous catheters). Patients needing intravascular access were randomised to 1 of 3 groups: Tegaderm CHG (938 patients), standard dressing (Tegaderm transparent film dressing; 476 patients) or highly‑adhesive dressing (Tegaderm HP transparent film dressing; 465 patients). Assessors were blinded to dressing type. Patients had their skin prepared with povidone‑iodine in alcohol or 0.5% chlorhexidine in alcohol. Dressings were replaced after 24 hours and then every 3 to 7 days depending on the centre, or as needed if there was leaking or soiling. The study follow‑up period was 48 hours after discharge from the intensive care unit.
Frequency of Change
The end of the central line can be taped out of the way when your child has a bath, please ensure that the end does not get submerged in the bath. Some families find it useful to place the bung in a plastic bag, using cling film or a sandwich bag and also tap the line(s) over the shoulders during bath time.
Based on evidence from the company, the External Assessment Centre and expert advice, the Committee was satisfied that Tegaderm CHG would not involve significant changes to current care pathways and the use of existing care bundles. If the dressing remains intact and there is no oozing then the dressing needs to be changed once a week by the children’s’ community team.
Medical Education
Richardson MC. Royal Society of Medicine Services International Congress and Symposium, Series No. 179, Harlow, Essex, UK: Royal Society of Medicine Services Limited; 1991:29-33. The Committee noted that the study evidence was largely from intensive care units in France that followed different skin preparation guidelines and that may have had more severely ill patients than those generally found in the UK. The Committee considered that this evidence was nevertheless generalisable to the UK, based on advice from experts and the External Assessment Centre and on the knowledge of its members.
RESULTS: Fifteen fingertip injuries were successfully treated with the conservative protocol. There were no significant complications or treatment failures in any of the patients. Wounds showed full re-epithelization in as little as two weeks and were healed by six to eight weeks. IV3000 dressings form a protective barrier around the IV to help prevent bacterial and viral infection
Indications
Cheyne Child Development: while you wait leaflet - Pre-School Age (Hammersmith and Fulham children)
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