The Effect of Using Sterile Drape during Permanent Central Venous Catheterization on Reduction of Infection Rate in Patients under Hemodialysis

Document Type : Original Article (s)

Authors

1 Assistant Professor, Department of General Surgery, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran

2 General Practitioner, School of Medicine, Isfahan University of medical sciences, Isfahan, Iran

3 Associate Professor, Department of Community Medicine, Isfahan University of Medical Sciences, Isfahan, Iran

Abstract

Background: Hemodialysis is one of the most significant alternatives for kidney transplantation which is dependent on efficient vascular access. Compared to arteriovenous fistulas (AVF), these catheters increase the risk of bacteremia more than 10 times. Infection is the second cause of death in patients under hemodialysis, and the cause of 30-60 percent of the central venous catheter replacement. To prevent catheter infection, foremost, we have to distinguish the risk factors and their effects. The plastic adhesive drape is used extensively to prevent the bacterial transmission from skin to the surgical site. Sterile drape utilization is a controversial discussion and there is no convincing evidence for disinfectant effect yet. Our purpose was is to investigate the sterile drape utilization to reduce the incidence of central venous catheter infection.Methods: A prospective randomized single-blind clinical trial was done. 80 internal jugular veins were embedded in two groups of 40 people (with and without sterile drape). The 2 groups were followed regarding the evidence of early infection.Findings: In the with sterile drape group, two patients on the third visit complained about redness of the catheter exit site, and in the without sterile drape group, one person on the third visit complained about secretion of the catheter exit site. No evidence of infection was detected by the physician. In without sterile drape group, one blood culture was done which was negative. No correlation was found between age, sex, weight, and the levels of creatinine and blood urea nitrogen (BUN) with the incidence of infection.Conclusion: In our research, utilization of sterile drape did not have any significant effect on reduction of catheter early infection.

Keywords

References

  1. Bohlke M, Uliano G, Barcellos FC. Hemodialysis catheter-related infection: prophylaxis, diagnosis and treatment. J Vasc Access 2015; 16(5): 347-55.
  2. Vascular Access Work Group. Clinical practice guidelines for vascular access. Am J Kidney Dis 2006; 48(Suppl 1): S248-S273.
  3. Santoro D, Benedetto F, Mondello P, Pipito N, Barilla D, Spinelli F, et al. Vascular access for hemodialysis: current perspectives. Int J Nephrol Renovasc Dis 2014; 7: 281-94.
  4. Patel PR, Kallen AJ, Arduino MJ. Epidemiology, surveillance, and prevention of bloodstream infections in hemodialysis patients. Am J Kidney Dis 2010; 56(3): 566-77.
  5. Allon M. Dialysis catheter-related bacteremia: Treatment and prophylaxis. Am J Kidney Dis 2004; 44(5): 779-91.
  6. Carrer S, Bocchi A, Bortolotti M, Braga N, Gilli G, Candini M, et al. Effect of different sterile barrier precautions and central venous catheter dressing on the skin colonization around the insertion site. Minerva Anestesiol 2005; 71(5): 197-206.
  7. Safdar N, Kluger DM, Maki DG. A review of risk factors for catheter-related bloodstream infection caused by percutaneously inserted, noncuffed central venous catheters: Implications for preventive strategies. Medicine (Baltimore) 2002; 81(6): 466-79.
  8. Maki DG, Stolz SM, Wheeler S, Mermel LA. Prevention of central venous catheter-related bloodstream infection by use of an antiseptic-impregnated catheter. A randomized, controlled trial. Ann Intern Med 1997; 127(4): 257-66.
  9. O'Grady NP, Alexander M, Dellinger EP, Gerberding JL, Heard SO, Maki DG, et al. Guidelines for the prevention of intravascular catheter-related infections. Centers for Disease Control and Prevention. MMWR Recomm Rep 2002; 51(RR-10): 1-29.
  10. Young EM, Commiskey ML, Wilson SJ. Translating evidence into practice to prevent central venous catheter-associated bloodstream infections: a systems-based intervention. Am J Infect Control 2006; 34(8): 503-6.
  11. Mimoz O, Lucet JC, Kerforne T, Pascal J, Souweine B, Goudet V, et al. Skin antisepsis with chlorhexidine-alcohol versus povidone iodine-alcohol, with and without skin scrubbing, for prevention of intravascular-catheter-related infection (CLEAN): an open-label, multicentre, randomised, controlled, two-by-two factorial trial. Lancet 2015; 386(10008): 2069-77.
  12. Atahan K, Cokmez A, Bekoglu M, Durak E, Tavusbay C, Tarcan E. The effect of antiseptic solution in central venous catheter care. Bratisl Lek Listy 2012; 113(9): 548-51.
  13. Sahli F, Feidjel R, Laalaoui R. Hemodialysis catheter-related infection: rates, risk factors and pathogens. J Infect Public Health 2017; 10(4): 403-8.
  14. Falk-Brynhildsen K, Soderquist B, Friberg O, Nilsson UG. Bacterial recolonization of the skin and wound contamination during cardiac surgery: a randomized controlled trial of the use of plastic adhesive drape compared with bare skin. J Hosp Infect 2013; 84(2): 151-8.
  15. Webster J, Alghamdi AA. Use of plastic adhesive drapes during surgery for preventing surgical site infection. Cochrane Database Syst Rev 2007; (4): CD006353.
  16. Maxwell JG, Ford CR, Peterson DE, Richards RC. Abdominal wound infections and plastic drape protectors. Am J Surg 1969; 118(6): 844-8.
  17. Yoshimura Y, Kubo S, Hirohashi K, Ogawa M, Morimoto K, Shirata K, et al. Plastic iodophor drape during liver surgery operative use of the iodophor-impregnated adhesive drape to prevent wound infection during high risk surgery. World J Surg 2003; 27(6): 685-8.
  18. Cordtz T, Schouenborg L, Laursen K, Daugaard HO, Buur K, Munk CB, et al. The effect of incisional plastic drapes and redisinfection of operation site on wound infection following caesarean section. J Hosp Infect 1989; 13(3): 267-72.
  19. Santoro D, Benedetto F, Mondello P, Pipito N, Barilla D, Spinelli F, et al. Vascular access for hemodialysis: Current perspectives. Int J Nephrol Renovasc Dis 2014; 7: 281-94.
  20. Moores N, Rosenblatt S, Prabhu A, Rosen M. Do iodine-impregnated adhesive surgical drapes reduce surgical site infections during open ventral hernia repair? A comparative analysis. Am Surg 2017; 83(6): 617-22.
  21. Ghonemy TA, Farag SE, Soliman SA, Amin EM, Zidan AA. Vascular access complications and risk factors in hemodialysis patients: A single center study. Alexandria Journal of Medicine 2016; 52(1): 67-71.
  22. Le Guillou V, Tavolacci MP, Baste JM, Hubscher C, Bedoit E, Bessou JP, et al. Surgical site infection after central venous catheter-related infection in cardiac surgery. Analysis of a cohort of 7557 patients. J Hosp Infect 2011; 79(3): 236-41.
  23. Andersen PT, Herlevsen P, Schaumburg H. A comparative study of 'Op-site' and 'Nobecutan gauze' dressings for central venous line care. J Hosp Infect 1986; 7(2): 161-8.
  24. News Rx, Atlanta. Science; New Findings Reported from Orebro University Hospital Describe Advances in Sciences [Online]. [cited 2013 Apr 14]; Available from: URL:
  25. https://search.proquest.com/docview/1375088087?accountid=41305
  26. Timsit JF, Mimoz O, Mourvillier B, Souweine B, Garrouste-Org, Alfandari S, et al. Randomized controlled trial of chlorhexidine dressing and highly adhesive dressing for preventing catheter-related infections in critically ill adults. Am J Respir Crit Care Med 2012; 186(12): 1272-8.
Journal of Isfahan Medical School
Volume 36, Issue 475 - Serial Number 475
March and April 2018
Pages 358-365

Files

History

  • Receive Date: 28 March 2018
  • Revise Date: 02 November 2024
  • Accept Date: 06 April 2022

Share

How to cite

Statistics