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Chlorhexidine gluconate–impregnated central access catheter dressings as a cause of erosive contact dermatitis: a report of 7 cases.
- Source :
-
JAMA dermatology [JAMA Dermatol] 2013 Feb; Vol. 149 (2), pp. 195-9. - Publication Year :
- 2013
-
Abstract
- Background: Chlorhexidine gluconate-impregnated dressings have become widely adopted as a means to reduce the risk for catheter-associated bloodstream infections. These dressings release antiseptic under occlusion onto the skin surrounding catheter insertion sites. Although chlorhexidine gluconate is a known cause of contact dermatitis, the phenotypic range of this adverse effect of chlorhexidine gluconate–impregnated dressings in critically ill patients has not been described.<br />Observations: We report 7 cases of erosive irritant contact dermatitis due to chlorhexidine gluconate-impregnated transparent dressings. Six of these patients were children (age range, 4 months to 2 years); the adult was a critically ill 62-year-old man. Four patients were immunosuppressed after solid organ transplant and all were receiving blood pressure support at the time of this reaction. The insertion sites of femoral catheters were involved in all but 1 case; 3 catheter sites were involved in the adult patient. Results of extensive infectious workups were negative. All lesions resolved with discontinuation of the chlorhexidine gluconate-containing dressings, local wound care, and alternative antimicrobial dressings.<br />Conclusions: Erosive contact dermatitis is an under-recognized complication of chlorhexidine gluconate-impregnated dressings. Health care providers should be aware of this risk, particularly in young children and immunosuppressed and/or critically ill patients, who may be more susceptible to the irritant effects of these dressings. When the dressings are used, patients should be monitored closely for skin breakdown.
- Subjects :
- Anti-Infective Agents, Local administration & dosage
Catheterization, Central Venous methods
Child, Preschool
Chlorhexidine administration & dosage
Chlorhexidine adverse effects
Critical Illness
Dermatitis, Irritant pathology
Female
Humans
Immunosuppressive Agents administration & dosage
Immunosuppressive Agents adverse effects
Infant
Male
Middle Aged
Occlusive Dressings adverse effects
Organ Transplantation methods
Sepsis etiology
Sepsis prevention & control
Anti-Infective Agents, Local adverse effects
Catheter-Related Infections prevention & control
Chlorhexidine analogs & derivatives
Dermatitis, Irritant etiology
Subjects
Details
- Language :
- English
- ISSN :
- 2168-6084
- Volume :
- 149
- Issue :
- 2
- Database :
- MEDLINE
- Journal :
- JAMA dermatology
- Publication Type :
- Academic Journal
- Accession number :
- 23560299
- Full Text :
- https://doi.org/10.1001/jamadermatol.2013.903