Frequence of Dressing Change and Bacterial Colonization in Pediatric Intensive Care Unit
Condition: Bacterial Infections
MeSH terms: Bacterial Infections
Study type: Interventional

Summary: 
      This study is non-inferiority trial design.The relationship between whether dressing change
      24hrs after CVC (central venous catheter) catheterization and bacterial colonization of the
      skin.
    

Detailed description: 
      Central venous catheter (CVC) was punctured directly through jugular vein, subclavian vein
      and femoral vein, and its tip is located in superior vena cava or inferior vena cava. CVC is
      widely used in ICU because of its kinds of advantages. However, CVC, as an invasive puncture
      method, may bring more complications. The incidence of central line associated bloodstream
      infection (CLABSI) was 1.33-31.6/1000 catheterization day , and the death rate due to CVC
      associated bloodstream infection is 3-5% . Therefore, various organizations have formulated
      guidelines for the prevention of CLABSI and best evidence summary . From October 2019 to
      April 2020, taking the children's hospital of Fudan University as the leading unit, PICU of
      children's Hospital Affiliated to Zhejiang University, Anhui children's Hospital, Xiamen
      children's Hospital, Shenzhen Children's Hospital and Guangzhou Women's and Children's
      medical center as the cooperation units, carried out children's central venous
      catheterization Multi center research on best practices of management and maintenance. It was
      found that changing dressings 24 hours after catheterization may increase the incidence of
      MARSI, and repeatedly exposing dressings may also increase the incidence of CLABSI. The
      research team returned to the original evidence and consulted the guidelines. It was found
      that: under the premise of achieving the maximum aseptic catheterization, the guidelines
      issued by various institutions did not mention that the application should be replaced 24
      hours after catheterization; however, the evidence was mentioned in the evidence summary, but
      there was no support from the relevant original literature. Therefore, it is worth discussing
      whether children need to change dressings 24 hours after catheterization. This study is
      non-inferiority trial design.
    

Intervention name(s): 24hrs dressings change; 7days dressings change
Intervention type(s): Other; Other
Intervention description(s): The first dressing change and sampling were completed 24 hours after catheterization in the operating room or PICU.When bedside nurse remove the dressing ,the researchers used 4 normal saline cotton swabs to wipe the skin under the dressing. Taking the puncture point as the center, 4 cotton swabs wipes 4 points in the northwest, northeast, Southeast and northeast direction 1cm away from the puncture point,separately.Then the specimen delivered to Laboratory..Then the second dressing change and sampling were completed 7days later(if there is no clinical indication occur,such leaking,blood).; The first dressing change and sampling were completed 7 days after catheterization in the operating room or PICU.When bedside nurse remove the dressing ,the researchers used 4 normal saline cotton swabs to wipe the skin under the dressing. Taking the puncture point as the center, 4 cotton swabs wipes 4 points in the northwest, northeast, Southeast and northeast direction 1cm away from the puncture point,separately.Then the specimen delivered to Laboratory..(if there is no clinical indication occur,such leaking,blood).
Allocation: Randomized
Intervention model: Parallel Assignment
Masking: Single (Outcomes Assessor)
Primary purpose: Prevention
Keywords: Central venous access device; dressing; bacterial colonization; medical adhesive-related skin injury