AW-04. Optimization of aseptic care techniques for central venous catheter in patients with hematological diseases
Tamara A. Gogoleva
RM Gorbacheva Research Institute, Pavlov University, St. Petersburg, Russia
Contact: Tamara A. Gogoleva, phone: +7 (911) 934-04-15, e-mail: email@example.com
Central venous access is a mandatory condition to perform allogeneic bone marrow transplantation and intensive therapy in patients with malignancies. Meanwhile, the central venous catheter (CVC) requires daily nursing care, like antiseptic treatment and changing of adhesive bandages. Painful skin irritation and catheter-associated infections are among the adverse events associated with changing these bandages. In order to reduce the severity of a pain syndrome, skin damage, and development of infectious complications, it is necessary to search and implement new methods of CVC care. ConvatecNiltac is a medical anti-adhesive spray which contains liquid silicone compounds for easier removal of adhesive bandages. Currently, there are no available studies representing its efficacy and safety in CVC care in the patients with hematological diseases.
Patients and methods
A total of 56 patients were included into the study with acute myeloid and lymphoblastic leukemia (n=31), chronic myelo- and lymphocytic leukemia (n=4), multiple myeloma (n=6), aplastic anemia (n=2), myelodysplastic syndrome (n=1), Hodgkin’s lymphoma (n=1), myelofibrosis (n=1). All patients were treated at the Department of Bone Marrow Transplantation of the R.M. Gorbacheva Memorial Research Institute of Pediatric Oncology, Hematology and Transplantology in 2021-2022. Their median age was 44 years (18-66). Self-adhesive bandages “Cosmopor” and “Tegaderm” were used as protective dressings for CVC. The Cosmopor patch was changed daily, the Tegaderm bandage was applied every 6 days. Treatment of the CVC injection site was carried out using 3% hydrogen peroxide, and chlorohexidine bigluconate solution (0.05%). The patients were divided into 2 groups: in the 1st group (n=20), the ConvatecNiltac spray was used to remove the bandage. In the control group (n=26), EcoBreeze antiseptic solution with isopropanol was used to this purpose. During the hospitalization period, the incidence of skin irritation, inflammation of CVC injection site, as well as incidence of systemic infectious complications was assessed. Statistical analysis was determined by the Chi-square test.
The incidence rates of skin irritation at the patch site were lower in the Niltac spray group compared to the controls (5% and 30.8%, p=0.03). There were no differences found in the incidence of infectious complications (febrile neutropenia (70% and 84.6%, p=0.4), sepsis (35% and 53.8%, p=0.33), as well as cases of inflammation at the CVC injection site (20% and 34.6%, p=0.44)) among the patients of both groups. There were no skin allergic reactions to ConvatecNiltac Spray in either case. Conclusion. Niltac spray for removing of CVC self-adhesive bandages causes significantly reduced incidence of skin irritation, but does not affect the risk of developing infectious complications in patients with malignancy.
Niltac, skin irritation, central venous catheter.