New exit-site care of tunneled cuffed catheter-Disinfectant-free cleaning with shower using tap water

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  • カフ付き皮下トンネル型カテーテル出口部の新しいケア方法―消毒薬を使わない，水道水によるシャワー洗浄法―
  • カフ ツキ ヒカ トンネルガタ カテーテル デグチブ ノ アタラシイ ケア ホウホウ ショウドクヤク オ ツカワナイ スイドウスイ ニ ヨル シャワー センジョウホウ
  • -Disinfectant-free cleaning with shower using tap water
  • ―消毒薬を使わない，水道水によるシャワー洗浄法―

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Abstract

To normalize the skin around tunneled cuffed catheter exit-sites and simplify care, we developed a new method of care in which the exit-site is washed with tap water and not disinfected. The subjects were 5 patients with tunneled cuffed catheter (Soft-Cell) managed between 2005 and 2007 at Sagamihara Kyodo Hospital and Hashimoto Minami Internal Medicine Clinic. While directly pouring ordinary tap water (approximately 40℃) onto the exit-site from a shower bottle, stains were removed using a swab. Then the water was wiped off with a non-sterile gauze or towel. Without disinfecting the exit-site skin, the site was protected with non-sterile gauze or tape. The exit site-skin was observed and photographed. Blood tests and bacterial culture of the exit-site skin and blood were performed. The 5 patients comprised 3 men and 2 women aged 63～84 years (mean : 73.0±8.1 years). The duration of cleaning was 36～210 days (mean : 107.4±75.1 days). With this method, the exit-site skin condition improved in all patients. An inflammatory reaction occurred in 1 patient who was referred to another hospital and the catheter was removed, but there was no sign of exit site infection. Various bacteria were detected on the exit site skin, but no organisms were isolated by blood culture. These findings indicate the safety and effectiveness of this method.

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