PD exit site: to bandage or not to bandage

[kickingandscreaming]

I would like to know whether it is really important to have a dressing on a well-healed PD catheter exit site or whether it can simply be allowed to "breathe" without being encumbered with gauze and tape (which always irritates my skin.)  I had my catheter installed back in April and it is totally sealed up.  Why is it necessary to keep a dressing on it?  I have had trouble with all the "cleansers" used on both my PD and my chest catheter.  At this point, my nurse no longer applies anti-bacterial cream as I got a rash from it.  And with my chest cath. the Hemo nurse uses only saline solution to clean it because my skin is so sensitive.  I am always itching from all the tape on both exit sites.

What are your thoughts on this? Thanks.

[Charlie B53]

As I understand it,  the body cannot and will not adhere to the plastic hose.  No way, no how.  No matter how 'tight' it seems to be, there is a direct open pathway for bacteria, or other nasties, to enter the body, very probably to cause infection.  Depending on the type of infection, easily and rapidly life threatening.

For this reason alone the 'site' should be kept covered except for cleaning and re-bandaging.

My skin can be quite sensitive to adhesives.  Some tapes will actually peel off the skin.  Others cause a rash.  The 'Cover-Roll Stretch' that my clinic uses sometimes causes water blisters to rise in reaction to the adhesive (?).   My PD Nurses have found that wiping the area with the betadine, leaving a 'coating' everywhere that the tape touches effective in preventing those water blisters.  They were really a pain as the blister would stick to the tape and peel away, leaving a raw sore that make it a trick to tape down the new bandage.

As for the ointment.  Immediately upon my cath placement I was asked to be included in a 'trial'.  O.K.

This trial was testing the efficiency of using Bee Honey in place of an anti-biotic ointment.     Seems since Biblical times Honey has been used as an ointment and is a natural anti-biotic.   All I can say is that it did the job for me.   You may need to talk with a Pharmacist to see if there is an OTC product or a prescription, or what.   

I can tell you that archaeologists have found sealed earthen jars well over a thousand years old full of Honey, and it was still safe edible, etc..  Do not know if that honey was ever heated, or simply drained from the comb.  I expect it to be UN-heated, retaining the natural enzymes.

Un-heated honey has been recommended at a dietary aide in treatment of some things.  An old Mechanic friend used about 2 oz daily claiming it kept his aching joints far better than any of the pills his Dr had prescribed.

[kickingandscreaming]

As far as  I know, the honey you're referring to is called Manuka honey.  I think all honeys have some antibacterial properties because bugs can't really thrive in so much sugar.  But it is Manuka that is special and has been shown to kill MRSA and other awful antibiotic resistant strains.  I have seen it in drug stores and I have seen bandages that are saturated with Manuka, but they cost a fortune.  I would be much more willing to use honey over anti-bacterial cream which has already given me a rash.  In in-center hemo, my nurse now only uses saline to clean off my chest cath, as I got a rash from the stronger stuff.

Has anybody tried using the "human" equivalent of "vet wrap" (AKA sensi-wrap) both to hold a gauze dressing in place without tape and to secure the PD cath/transfer set?  it's kind of like a stretchy, gauzy but sturdier, ace-like bandage that adheres to itself.  It's used on a lot of pet injuries because it's flexible and can take on any shape and it sticks to itself and is hard for the animal to unravel.  It's made for humans too.

[Charlie B53]

I've got 10 rolls of the three or four inch tan.  The VA Hosp tends to load me up when I need anything.  I also have a couple of the two inch white from Wal-Greens.  Not using any now that that long term wound has finally healed.

I know it isn't cheap, but I love the stuff.  Couldn't use anything else on my leg as everything else simply peeled my skin off making for even more damage than the original would.   Took a year before they started to seriously do anything about it.  When I finally managed to get into the Wound Clinic the Ladies cringed when they saw how bad it was and for how long I had been put off.  So they filled a bag with supplies and I got an even bigger box full in the mail a few days later.  I am well stocked with some spendy stuff.

This stuff is great for going around an arm or leg.  It would take much more to go around a chest.    I tend to leave dressings on for days, not changing daily, nor every-other.  The end of this stuff can come loose.  I use a cheaper but very effective tape and run a couple of strips parallel to the wrap over the end so to assist it to stay on.   No adhesive to my skin, only on the wrap.

Hope this is helpful.

I would definitely ask your team, and Pharmacist about using honey.  It may be great for you.  But ask to be sure.