what size Tegaderm

[RightSide]

For hemodialysis catheters, what size Tegaderm do you use?

Is the 4 x 4 3/4" one big enough?  The lowest price I found is $1.03 each.
How about the 4 x 6 1/8" one?  The lowest price I found is $47.61 for 25.

[silverhead]

We do in home Hemo and those type supplies would be furnished to us......

[monrein]

These are supplied to all patients here, no matter where you dialyze but I would suggest you measure your site and take it from there.  They're expensive so you don't want too big but you need to make sure they're big enough for good coverage.

[alrightstill]

I use a 4x4 but I cut it into 4 pieces.  My dressing is small so 1/4 of the 4x4 covers the site and then I use another one to tape down the lower part of the cath (before the clamps).

[nursewratchet]

Your clinic should supply those. Always, it is considered part of your treatment, and the clinic is paid to have them for you.  Ask them for an extra one if you need it, they should be able to provide an extra one here and there. 

[paddbear0000]

I want to use Tegaderm over my chest cath so I can shower. Does the entire cath need to be covered or certain parts? And where can I get some (besides from a dialysis clinic)? CVS has some, but they aren't very big at all.

[monrein]

Be very careful with showering Paddbear.   I know others have done it with the Tegaderms but I would not myself.  I'd go for a Korshield if I absolutely HAD to shower but I'm a wuss when it comes to the threat of infection going into my heart.

http://www.korshield.com/

[willieandwinnie]

paddlebear, monrein is so right. Len had a catheter for over a year and he use the hand held shower. I washed his hair in the kitchen sink. Please be careful, you don't want to get an infection. 

[paddbear0000]

My surgeon used the stuff to cover my other suture sites of my fistula access and said it was waterproof and could shower. He also used it to cover the part of the cath where it's going in my skin. I just don't understand why taking a shower would cause infection. I would think the soap and water would help rid the area of infection causing bacteria.

[monrein]

You'll have to decide for yourself Paddbear but here is some info from University Hospital in Augusta Georgia.  Your surgeon should read it.  This is exactly what I was told.  The risk is NOT worth it.  You could maybe do it and get away with it but in my opinion that's an unnecessary chance to take.

WHAT HAPPENS IN A PERMACATH INSERTION?

A Permacath insertion is the placement of a special IV line into the blood vessel in your neck or upper chest just under the collarbone. This type of catheter is used for short-term dialysis treatment. The catheter is then threaded into the right side of your heart (right atrium). The procedure involves creating a tunnel under the skin to thread the other portion of the catheter out through the skin. This tunneling process greatly reduces the risk of an infection and allows the catheter to remain in for a long period of time (one-12 months). The procedure involves complete sterility and the physician, nurse and X-ray tech will wear a mask, sterile gown and lead apron. A nurse will start an IV in your hand or arm and complete the history questionnaire. You will be given sedation through the IV, and the physician will scrub the area on the right or left chest or neck with a Chlorhexadine solution. The physician will ask you to turn your head to the other side while he places a drape over your face and neck to keep the area sterile. The physician will numb your skin with Lidocaine and you will be asked throughout the procedure if you are having any pain. Please tell the nurse or physician and more sedation and pain medication will be given. You will feel some pressure on your neck. The procedure will take 15-45 minutes. After the procedure, a dressing will be applied to cover the insertion site.

WHAT ACTIVITIES CAN I PERFORM AFTER I GO HOME?

You may resume your normal activities except: Do not shower the day of your procedure or perform heavy activities such as lifting. Do not remove the dressing until you are instructed to do so. You will be able to drive, but it is advisable to have someone to drive you home.

PATIENT INSTRUCTIONS POST PROCEDURE

PLEASE do not shower or get the catheter wet.

You may get into a bathtub, but only get wet to the nipple line (mid-chest).
You will need to continue your routine dialysis treatments.
Please inform your doctor of any fever or pain, redness or drainage at the catheter site.
You may have a small amount of bleeding at the site. Report any bleeding that continues or increases to your physician.
You may have mild pain for one to two days. You may take whatever pain medications you use for minor aches and pains.
FREQUENTLY ASKED QUESTIONS

What should I do if the catheter does not work?
If the catheter is not working, the dialysis center will notify your physician to discuss further action or treatment.

How long will the catheter last?
The catheter will last anywhere from one-12 months depending on its care, your freedom from any infections and how long it needs to be used. The catheter is often used while a new graft is healing and as a temporary measure for short term (less than six months dialysis).

Why must the catheter stay dry? What should I do if it gets wet?
Getting the catheter wet greatly increases the risk of an infection at the catheter site by allowing germs to enter or contaminate the catheter. If the catheter becomes wet accidentally, promptly dry it off and cover it with dry sterile gauze dressing (available at any drug store). Notify your physician. Do not apply any antibiotic lotions or other cleaning solutions as they may damage the catheter and/or make it brittle and at higher risk for breaking.

[frankenarm]

When I had my cath, the nurse who discharged my gave me a pile of Aquaguards, and they worked just fine. never had any problem. Also, if a ran out, i would double reinforce a section of garbage bag, and use the plastic tape to seal it around the cath. 5 months with the cath, no problem with infection, it never got wet. worked just fine for me.

[qwerty]

Your clinic should supply those. Always, it is considered part of your treatment, and the clinic is paid to have them for you.  Ask them for an extra one if you need it, they should be able to provide an extra one here and there. 

Not all clinics provide the extra dressings for patients. Our new dressings (cloth) get changed only weekly and we have had a 0 infection rate since we changed to this policy. (This has been in place for the last 10 months now compared to the 1-3 infection rate a month previously utilizing tegaderm). Any patient who requires a new dressing due to visually displaced or dirty then we do the extra . If by chance they just "want" it changed every treatment then they have to bring additional. Also if they request tegraderm or other dressing other than the type we use they must provide them. We are not permitted to provide extras for them to take home either. Your larger corporate clinics may provide the extra as they generally have the extra funds to do so, the smaller private clinics may not. It's not just our clinic either. Most the other clinics in our area with exception of Davita have instituted the same practice.

[monrein]

When I had my cath I preferred the "cloth" dressings to the tegaderm because I found that I developed horrid itching and a rash from the tegaderm.  However, I used to perspire a fair bit at they gym and so the dressing would usually begin to peel off.  They changed it almost every session (three times a week at that time) no problem and they gave me extra to do it in between if necessary. 

[paddbear0000]

I ended up getting two different sizes of the tegaderm from CVS (actually, there are Nexcare brand labels over the tegaderm labels for some reason). A larger one and a smaller one cover my entire cath area perfectly. The ones I got have gauze squares pre-attached which makes them very convenient. I don't have to balance trying to hold guaze in place while sticking on the clear patch, plus, with the pad, my cath  deosn't get all sticky. I love it!

[qwerty]

When I had my cath I preferred the "cloth" dressings to the tegaderm because I found that I developed horrid itching and a rash from the tegaderm.  However, I used to perspire a fair bit at they gym and so the dressing would usually begin to peel off.  They changed it almost every session (three times a week at that time) no problem and they gave me extra to do it in between if necessary. 

We use the 4x4 cloth and they have the preattached gauze underneath. Most my patients love them!!! I have a few who prefer the smaller ones and bring them in. With the tegraderm we usually had to use 2-4 for each dressing and when patients perspired they would get damp and peel. Lot of patients complained of itching with the tegraderm also. With these we use one. We also have small pre-preps to put around the area to help ensure they stick well. Also not having all the goop from the tegraderm adhesive on the catheters is great. We dont tape the tips any more either and I do beleive these practices have been solely responsible for the decrease in our infection rates. I have a few who use the big composite dressings specific for showering with catheters and they report they work very well.

[Auntie V]

I buy the cascara at Walmart. I have been using them for Mom's skin rips for over a year now.

When I asked about extra dressings for her cath I was told that I should never need to change it so I do not need extras. I have some tegaderm and the nexcare on hand so I did not push the issue but decided if one started to come off I would be reinforcing it before I would risk having an infection.

I have also started seeing the nexcare in the grocery store within the last month or two.

[paddbear0000]

My pharmacy ordered me a box of Nexcare/Tegaderm's 4 1/2"x6" (that's the approx. size) the day before yesterday and I got them yesterday. I've found them in regular stores, but everyone sells the patches individually and they cost anywhere from $3.50 to $4.50 each! I was able to get a whole box of 12  from my pharmacy fro $40 (without insurance), which work out to $3.39 each. And they have a built in pad on them so they don't get the cath all sticky, which I love! I'm so thrilled! Hey, it doesn't take much to amuse me.   

[pdpatty]

I want to use Tegaderm over my chest cath so I can shower. Does the entire cath need to be covered or certain parts? And where can I get some (besides from a dialysis clinic)? CVS has some, but they aren't very big at all.

Be very carefull showering.
What I do is use PressN Seal .I cut off a piece that is just big enough to cover the plastic bandage,I press it down good and tuck the length under the cath. I TAPE the first layer down with a water proof tape. I then cover this with a second leyer of PressnSeal  that is wider than the first and really tape this down  to make a good seal. The ends are tucked under breast.

I use a hand held shower sprayer and try to avoid spraying the cath site directly. So far,my site has not gotten wey.

[meadowlandsnj]

Amazon.com has Tegaderm--50 for 32.50$.  Just bought a box of them.
3M Tegaderm Transparent Dressing with Label 4" x 4 3/4" (10 x 12 cm)50 per Box #1626W

That's the cheapest I've ever seen them.  I use them for the Emla cream on my fistula.

Donna

[breezysummerday]

And they have a built in pad on them so they don't get the cath all sticky

That type of dressing is sometimes called an 'island dressing', just fyi....

One other thought I have is to be careful when you are cleaning around
your house, my s/o (the one on dialysis) got his cath wet when washing
the car, forgot all about his cath. 

[paddbear0000]

I drive my car throgh the automatic car wash!