Dressings for the central venous catheter to prevent infection in patients undergoing hematopoietic stem cell transplantation: a systematic review and meta-analysis.

Autor: de Campos Pereira Silveira RC; General and Specialized Nursing Department, Ribeirão Preto College of Nursing, WHO Collaborating Centre for Nursing Research Development, University of São Paulo, Bandeirantes Avenue, 3900. Campus - Monte Alegre, Ribeirão Preto, SP, 14040-902, Brazil. recris@eerp.usp.br., Dos Reis PED; Nursing Department, School of Health Sciences, University of Brasília, University Campus - Darcy Ribeiro b.b - Asa Norte, Brasília, DF, 70910-900, Brazil., Ferreira EB; Nursing Department, School of Health Sciences, University of Brasília, University Campus - Darcy Ribeiro b.b - Asa Norte, Brasília, DF, 70910-900, Brazil., Braga FTMM; General and Specialized Nursing Department, Ribeirão Preto College of Nursing, WHO Collaborating Centre for Nursing Research Development, University of São Paulo, Bandeirantes Avenue, 3900. Campus - Monte Alegre, Ribeirão Preto, SP, 14040-902, Brazil., Galvão CM; General and Specialized Nursing Department, Ribeirão Preto College of Nursing, WHO Collaborating Centre for Nursing Research Development, University of São Paulo, Bandeirantes Avenue, 3900. Campus - Monte Alegre, Ribeirão Preto, SP, 14040-902, Brazil., Clark AM; University of Alberta, 116 St & 85 Ave, Edmonton, AB, T6G 2R3, Canada.
Jazyk: angličtina
Zdroj: Supportive care in cancer : official journal of the Multinational Association of Supportive Care in Cancer [Support Care Cancer] 2020 Feb; Vol. 28 (2), pp. 425-438. Date of Electronic Publication: 2019 Sep 06.
DOI: 10.1007/s00520-019-05065-9
Abstrakt: Purpose: To identify the most effective dressing for covering long-term central venous catheter exit site to prevent catheter-related infections and skin irritation in patients undergoing hematopoietic stem cell transplantation.
Methods: Systematic Review. The search was performed in the following electronic databases: CINAHL, Cochrane Library CENTRAL, EMBASE, LILACS, PubMed, Scopus, and Web of Science. Google Scholar was used for the gray literature search.
Results: Seven studies were included which tested different arrangements of dressings: sterilized gauze and adhesive tape with a transparent polyurethane film (n = 2), transparent polyurethane film with a different replacement interval frequency (n = 2), transparent polyurethane film with and without chlorhexidine released continuously by the dressing at the site of intravascular catheter insertion (n = 2), and dressings vs. no dressings (n = 1). The meta-analysis for catheter-related infection prevention showed no difference between type of dressing (RR 1.76, [95% CI 0.82; 3.75], I 2 0%) and for the replacement frequency at different intervals (RR 1.04, [95% CI 0.67; 1.61], I 2 0%). The meta-analysis for skin irritation evaluated the transparent polyurethane film replacement frequency and indicated that a longer dressing replacement interval (10 to 15 days) reduces the risk of developing this outcome (RR 0.71, 0.52; 0.96, 95% CI, I 2 24%).
Conclusions: Regarding the type of the dressing, there is no evidence indicating the best dressing. Although there is no evidence available for the ideal replacement frequency, the risk to develop skin irritation is reduced in longer dressing replacements intervals.
Databáze: MEDLINE
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