Technique in catheter placement is important. The superficial cuff if placed appropriately would result in a well healed exit site. The exit site would lead to a blind sinus with the end at the fibrosed Dacron cuff. I find that, after each shower with cleansing of the exit site with normal shower soap and water, followed by dabbing it dry, one does not need to do any dressing with povidone and topical antibiotic application. The healthy exit site can be left without any gauze covering and the end of catheter with transfer set can be safely immobilized to prevent accidental pulling and traction. In fact without the gauze covering, it prevents chronic irritation from the plaster, catheter degradation from antiseptics, and free sinus discharge from any debris collection. I have practiced this on few patients and they do well. What do you think?

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Bee BC, Doctor/MD from Malaysia asked
Technique in catheter placement is important. The superficial cuff if placed appropriately would result in a well healed exit site. The exit site would lead to a blind sinus with the end at the fibrosed Dacron cuff. I find that, after each shower with cleansing of the exit site with normal shower soap and water, followed by dabbing it dry, one does not need to do any dressing with povidone and topical antibiotic application. The healthy exit site can be left without any gauze covering and the end of catheter with transfer set can be safely immobilized to prevent accidental pulling and traction. In fact without the gauze covering, it prevents chronic irritation from the plaster, catheter degradation from antiseptics, and free sinus discharge from any debris collection. I have practiced this on few patients and they do well. What do you think?

1 answer

I think it is appropriate in selected patients with well-healed exit sites and tunnel tracts. One has to be very careful before offering it all patients.

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