We are having so much trouble with Annabel's central line dressing. Any bandage we have used so far is causing her skin to have issues. She claws and scratch at the bandage and she has never been one to scratch. I have contacted our company that supplies her TPN and have been told this is all they have. I am including a picture of the best dressing for her site but again it caused problems with her skin. The one in the picture is called Sorba-View. Other bandages have been tegaderm (sp?), IV 3000, Medipore plus Pad, and one that comes with the dressing change kit. I was hoping that making this post maybe some of you that have central lines would have some other ideas. So please, if you know of any other solution please let me know. My email is suzyque92@hotmail.com
At this point we are doing daily dressing changes and that is not good. When we began it was weekly then a few times a week and now more often. You don't want to do changes often due to infection.
Thank you to everyone who reads and prays and I know this post won't be for everyone.
13 comments:
We are praying for you! Love, Annabel Leigh and Ava Joy
Oh no :( Cathy I wish I had words of wisdom, but Tegaderm is one of the one things that doesn't tear up Emily's skin. I hope someone else has a brilliant suggestion!!
Hi Cathy,
Just read about the problems you are having with the central line dressing. I have access to people who know tons about this kind of thing. My diabetes group is always discussing better dressings for their kiddos' insulin pump insertion sites. The dressings maybe different, though, sizewise and such, but if it was more gentle maybe you could make it work for Annabel. Anyway, I will see what some of them say and get back to you.
"To grow Christlike character you must experience some undeserved suffering in your life. Don't waste it!" Rick Warren
Holly ( Des Moines, IA) -- wife of Mike
mom of Morgan (13 yrs. old) unbalanced translocation resulting in partial t18q and partial monosomy 9p
dx'd with type 1 diabetes 03-17-08, enjoying the honeymoon
I was going to suggest Tegaderm as well.....don't know if you've tried it, or if it will even work with the central line.....hope you find something! Hugs!!!
Praying for a good solution. Kiss that sweet tummy for me.
Love you girls!!!
Love y'all, Ms. Cathy, and hope you find something that works ASAP!
Could it be a latex allergy? I don't know if there is latex in the bandages you are using, but it's definately something to consider. Hope you can figure this out so sweet little Annabel can be more comfortable!
Cathy,
I am going to copy some of the responses I got about the dressing for Annabel's central line:
"Have they tried the tegaderm HP (the hypoallergenic version of tegaderm) or just the regular tegaderm? "
"What about Hypafix. And do they use anything beneath the dressing? If not I'd recommend Cavilon. We use that beneath pump and sensor sites, and can really see a difference."
"I have an embroidery design for a pad to put around feeding tubes. I can make a few and send them to you. I don't know if it is what she needs, but you can see if it works."
"We use Opsite, which hasn't been mentioned. An advantage of Opsite if it works for them is that it is very economical. We pay $25.00 out of pocket for a roll that lasts us around 8 months. You can also cut it to the exact size you need."
"we also like hypfix."
"Also Bard Protective Barrier Film. We got that to use under Dex sites where Yo is allergic. It worked. I can't say it was perfect, but we did see a difference. "
"We used cover-roll stretch from BSN medical. I think it's the same as something else though and I can't remember what Hopefully someone will chime in.
Also, the Tincture of benzoin spray by Smith and Nephew is supposed to provide better adhesive AND a barrier."
"Holly, I'm sensitive/allergic to all the tapes as well, soi is my CDE, she disscussed it with a speacialist at the hospital she works at and advised her to only use 1 type of tape for 3 to 4 days, then change it. I now have 4 types of tape, and change them religiously. "Apparently" this tricks the skin. For the past 6 months, I've had no skin ifections or irritatin from the tapes. So it's been working for me."
Cathy, let me know if you have any questions or want links on where to find some of this "stuff." I can contact any of these people and get the info. for you. Good luck with this. I hate to think of Annabel having skin problems from the tape on top of everything else.
the below links are to websites for little ones living with EB - their parents might be able to suggest good dressings:
http://patriceandmattwilliams.blogspot.com/2011/01/wheres-snow.html
http://randycourtneytripproth.blogspot.com/
http://careforanabella.blogspot.com/
I have copy and pasted some of the comments I have received via emails from my last post. There are so many and we are investigating our option to try. I want to thank everyone who has taken time to write to us. This one below is from a family who just lost their sweet daughter in October. I pray for this family as they reach out to other. I am so touched by all these suggestions.
Hi There,
One of our blog readers sent us your question about central line dressings that are not irritating to the skin. Our daughter had Recessive Dystrophic Epidermolysis Bullosa (EB for short) which is a severe and life threatening skin disorder. She lost her life in October after undergoing a bone marrow transplant. Kids with EB need special dressings as normal adhesives will rip their skin right off. Our daughter had several central lines so we got pretty good ad dressing them.
I recommend any products from molnlycke: http://molnlycke.us/
They have a technology called Safetac that is just sticky enough to stay in place but gentle on the skin. Some of the specific products we used on her central line were Mepilex, Mepilex Border, Mepilex Transfer and Mepitac to keep it all in place. Some people also use Mepiform instead of tegaderm but we never had much success with it. Experiment and see what works.
I hope this was helpful.
A
I also want to thank Holly and Momma Betchan for helping put me in touch with these other families.
Thank you...it makes me realize why I blog and how much help and caring there is out there! Thank you!
When I was on continuous ivs I was given tegaderm but after about a week I started to itch like crazy.. then they started to rotate with other choices.
Sending huge prayers for your sweet girl!
Penny
Cathy, Mepilex was also what we used for Mallorie for her CPAP - they made a soft cushion pad that can stick and then pull off without hurting the skin - we reused the same little rectangle over and over several times under the tubing to cushion where it would press on her forehead. It was mentioned in one of these comments, so I wonder also if that was an option. In Houston they were trialing that instead of Duoderm, because it was easier on the skin and had some sort of antibiotic properties, too? And I know the kids with EB often use it. I don't know how strong it would be as a permanent adhesive for a central line, as you want the dressing to really stay secured ... but maybe doing like someone mentioned, rotating through tapes that you could put over the Mepilex .. getting the tape just beyond the edges of the pad? I think that idea of switching out diff types of tapes sounds interesting.
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