Just wanted to get a feel for what most centers are using to clean their long-term cathter sites during dressing changes. I am hearing from some of our nurses that betadine harms the catheters

We use Chlorhexadine Scrub/ChloraPrep Applicator, apply a BioPatch over the exit site and the dress with a clear dressing, currently using Tegederm IV. Some catheter materials are damaged by ETOH, others by Betadine, and I would imagine that some will be by Chlorhexadine. One would need access to the Catheter care information, specific to that brand, to determine what cleansing agent is appropriate. And of course, your client's reaction to that cleanser.

There are several things to note when using a cather site prep. The CDC recommends Chlorahexidine. WE use Chloraprep. It is a solution not a scrub. Please beware that you want a solution not a scrub. Any scrub will leave a soapy film that will lead to possible infection.

Supposedly, there is a new Chloraprep swabstick coming out. The applicator we use is over a dollar a unit. The new one will be under a dollar.

For catheter site care, we use Alcav50 solution, which is dilute bleach in sterile water. We used to use betadine but were informed by vascular surgery that some catheters deteriorate rapidly from contact with betadine. I read somewhere that there are microorganisms that can actually live in betadine solution, but not in bleach solution. We have had almost no complaints of skin irritation. Some patients and their families however have complained about bleach spots on dark clothing. I want to add that no solution is going to overcome the problem of patients who do not keep the catheter site dry and the dressing intact between dressings. Education and reinforcement of good catheter site protection at home are the key to prevention.

The new Chloraprep Swabsticks are available and samples are being shipped all over the country for dialysis. If you haven't received one, try contacting the manufacture, Medi-Flex.

Dave, I don't think alcavis50 is for site care. Alcalvis Int. makes a hypochlorite solution called Exsept designed for site care. We use Alcalvis50 for cleansing of the line prior to tx and at termination of tx, not for site care. You may want to check in on this to be sure that such a highly concentrated solution isn't harming your patient's skin.

Professional Disposables is launching a new line of CHG based swab (prep pads) and swabsticks in early 2006. The products are supposed to be very cost effective. This will give everyone the ability to use a prep pad with CHG - great for fistula site care