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Chlorhexidine gluconate–impregnated central access catheter dressings as a cause of erosive contact dermatitis: a report of 7 cases.

Authors :
Weitz NA
Lauren CT
Weiser JA
LeBoeuf NR
Grossman ME
Biagas K
Garzon MC
Morel KD
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.

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