my neph doesn't like the clear dressings? interesting...

[sullidog]

Does anyone have a neph that doesn't like the clear dressings on a catheter? Mine doesn't. He says it's a good way to get infection. I don't understand as as long as I've been on dialysis, that's the only dressings that were used, heck even when they are put in the radiologists use the clear dressings, but apparently they are bad for us? Now we have to use the island dressings which I don't like because in my oppinion they don't stick as well as the clear/tegaderms. I think my neph is great but this thing about the dressing has got me disagreeing. I'd rather have a dressing that sticks better and is bad for me rather then a dressing that doesn't stick and comes off easily, at least it's covered!

[fearless]

I'm not sure what a clear dressing is.  The clinic wanted to put a dressing on mine that was a gauze area (about 2" square) surrounded by clear adhesive (about another 2" all the way around) but it was really tearing up my skin from having it pulled off every other day.  Plus I think i was allergic.  Now they use paper tape and just tape the same size gauze over the wound.  My skin is still not liking it, but it's better than the first kind. (for me)

[sullidog]

it's called tegaderm, it's the same one they use for IV's

[Cordelia]

I would personally think, just from personal experience myself using the clear bandage is that it would be the BETTER choice just because they are so transparent, you can see what's "going on" underneath if there is an infection brewing. What your neph wants, does not make any sense to me either.          

In my experience when I wore that clear bandage it made me itch and become severely rashed I was red and I had to stop wearing the bandage all togehter BUT at least I can honestly say I liked that I could see my exit access with it.

[fearless]

I bet the dressing I've been given is an "island" dressing.  The island is the little square of gauze in the center of what seems like Scotch tape.  It's really nasty and tears up your skin.  The tegaderm sounds like it's probably better, and more expensive 

[Riki]

Tegaderm are pretty much the same thing.. they're clear, with no gauze.  I used them for emla cream, but they were used for the dressing on my line, and for the sterile dressing on my PD cath.

I get the small ones to use on my arm for 39 cents each at the drug store

[sullidog]

Well I do have some tegaderm and I'm using it, if he nor the center like it well that's just too bad, like I said that island dressing sucks. Fearless the island dressing is like a cloth or some type of fabrick dressing. At least that's what it feels like to me anyways.

[Restorer]

An island dressing (the ones actually labeled "island dressing" that I've been given) is 4x4 fabric with adhesive, with a non-adhesive 2x2 square of gauze in the middle. My last two dialysis centers used those exclusively.

At my current center, they put a 2x2 square of gauze over the exit site of my tunneled hemo catheter (just sitting there temporarily), then a 4 x 4 3/4 clear Tegaderm dressing over that. It might be irritating my skin, but I like it because it makes showering easier - I have the same Tegaderms at home, and I only need to use two to cover the entire catheter now, and there's less margin for it to peel up and water to get in.

[Quickfeet]

With my pd catheter, it was explained to me that the clear bandages like tegaderm hold in too much moisture. Moisture helps breed bacteria. The gauze type bandage allows the site to be much dryer. I was having mild infections when I used tegaderm. Now that I don't use any bandage at all, I don't have a problem with infections.

[sullidog]

that's what was explained to me too, but since the island makes me itch really bad and irritate my skin I really have no choice, in other words, I guess I'm saying then to my doctor that I'd rather get an infection than itch to death.

[fearless]

yeah, I agree.  The "island" dressing has torn up my skin and caused it to itch like crazy.

[Riki]

all adhesive dressings make me itch, anything from tegaderm to mepore to plain old bandaids and paper tape.  I grin and bear it, and try not to scratch.

When I was on PD, I used to scratch through the medipore tape dressings that I used.  At least, since it wasn't sterile, if I scratched through it, I could take it off and put another one on.

[Joe]

I'm on PD and used to use paper tape to tie everything down. I tried the island dressing, but it itched and burned unbelievably. Now I am not using anything, I just tuck the catheter end into my PD belt to stabilize it and go.

[Riki]

I'm on PD and used to use paper tape to tie everything down. I tried the island dressing, but it itched and burned unbelievably. Now I am not using anything, I just tuck the catheter end into my PD belt to stabilize it and go.

I asked about that when I was training back in 2001.  As a child, I was using the shower technique for dressings.  I asked about using that technique, or just leaving a dressing off, and the looks that I got from the training nurses, you have thought I'd just called their first born a nasty name.  I was surprised that I knew more about dressings than they did, as the shower technique was a big nono to them, after I explained to them what it was.

[sullidog]

I asked his nurse about it today. She said he says it is ok if gause is underneath it, covering the exit site. I guess that he found a few patients with a lot of moisture at the exit sight while using that dressing.

[bleija]

the issue with the tegaderm is that theres no air flow, condensation can build up like it if u sweat and that it brewing ground for infection

[Emerson Burick]

For what it's worth, I don't wear any gauze at all over my PD site. Between ripping out my belly hair and irritating the skin it seemed pointless once the incision healed. (I tried the mesh tube nonsense to hold the tube in place as well, but that was more trouble than it was worth.) Now I just use two squares of medipore tape and tape the PD valve on my site side, under the armpit. Easy to clean in the shower, plenty of air circulation under my shirt. Apparently I'm the only one at my clinic who does that, but it works for me, and my dialysis team always says that my site looks great.

[Riki]

Your PD site must be a lot higher than mine was, cuz the tubing wouldn't reach my armpit. *L*  There really wasn't much to the tubing, really.  It was that short I didn't need to tape it to anything

[Emerson Burick]

Your PD site must be a lot higher than mine was, cuz the tubing wouldn't reach my armpit. *L*  There really wasn't much to the tubing, really.  It was that short I didn't need to tape it to anything

Your doctors must be mean with the tubing. I can't imagine it would be to just let it swing the the breeze. The few times I've had a tape failure in public I stuff everything in my pocket and leave part of my shirt out to cover the tube loop.

[bleija]

ive done the pocket hide at work, then i forgot about it until i pulled my pants down to use the bathroom, nearly puilled the thing right out lol <---- only bc its Christmas

[Riki]

Your PD site must be a lot higher than mine was, cuz the tubing wouldn't reach my armpit. *L*  There really wasn't much to the tubing, really.  It was that short I didn't need to tape it to anything

Your doctors must be mean with the tubing. I can't imagine it would be to just let it swing the the breeze. The few times I've had a tape failure in public I stuff everything in my pocket and leave part of my shirt out to cover the tube loop.

Even with the extension on, my tubing wasn't long enough to swing anywhere.  I usually just tucked it into my underwear.  It kept it close to me, and nobody could see it

[Lovebelle]

I know my Dialysis clinic did not like to use Tegaderm (clear bandages) because 1) They are expensive and 2) Because they are not porous. I guess Theoretically it is not could to let any wound (including exit sites) to be completely suffocated for long periods of time it also delays healing. If any debris or anything is missed it could breed infection. Other dressings (i.e. bandaids, gauze/tape) are porous and lets area breathe while still keeping it protected. This is the only thing I can think of, but every doctor has their own views and preferences. I personally liked the clear tegaderm dressing because it was more gentle on my skin (I get severe sores from tape). So I would periodically switch off to give my skin a break.

[RenalSurvivorDotCA]

I use two of these sandwiched over my chest cath. They allow site breathing yet protect the site. I even shower with it. I also cover the catheter ends with a small ziplock  baggie.

ETA - Whoa!  Sorry for the hugeness of the pic....

[Riki]

Tegaderm are not waterproof.  I know this from when I was on PD and they were used for my sterile dressing.  I had to wait till the nurse was here before I could shower so that she could immediately put on a new dressing after I was finished.  The gauze underneath the Tegaderm was always soaked.