+ Site Statistics
+ Search Articles
+ PDF Full Text Service
How our service works
Request PDF Full Text
+ Follow Us
Follow on Facebook
Follow on Twitter
Follow on LinkedIn
+ Subscribe to Site Feeds
Most Shared
PDF Full Text
+ Translate
+ Recently Requested

Chlorhexidine gluconate–impregnated central access catheter dressings as a cause of erosive contact dermatitis: a report of 7 cases



Chlorhexidine gluconate–impregnated central access catheter dressings as a cause of erosive contact dermatitis: a report of 7 cases



JAMA Dermatology 149(2): 195-199



Chlorhexidine gluconate-impregnated dressings have become widely adopted as a means to reduce the risk for catheter-associated bloodstream infections. These dressings release antiseptic under occlusion onto the skin surrounding catheter insertion sites. Although chlorhexidine gluconate is a known cause of contact dermatitis, the phenotypic range of this adverse effect of chlorhexidine gluconate–impregnated dressings in critically ill patients has not been described. We report 7 cases of erosive irritant contact dermatitis due to chlorhexidine gluconate-impregnated transparent dressings. Six of these patients were children (age range, 4 months to 2 years); the adult was a critically ill 62-year-old man. Four patients were immunosuppressed after solid organ transplant and all were receiving blood pressure support at the time of this reaction. The insertion sites of femoral catheters were involved in all but 1 case; 3 catheter sites were involved in the adult patient. Results of extensive infectious workups were negative. All lesions resolved with discontinuation of the chlorhexidine gluconate-containing dressings, local wound care, and alternative antimicrobial dressings. Erosive contact dermatitis is an under-recognized complication of chlorhexidine gluconate-impregnated dressings. Health care providers should be aware of this risk, particularly in young children and immunosuppressed and/or critically ill patients, who may be more susceptible to the irritant effects of these dressings. When the dressings are used, patients should be monitored closely for skin breakdown.

Please choose payment method:






(PDF emailed within 0-6 h: $19.90)

Accession: 052066390

Download citation: RISBibTeXText

PMID: 23560299

DOI: 10.1001/jamadermatol.2013.903


Related references

Prevention of central venous catheter related infections with chlorhexidine gluconate impregnated wound dressings: a randomized controlled trial. Annals of Hematology 88(3): 267-272, 2009

Catheter-Related Bloodstream Infections during Use of Chlorhexidine Gluconate-Impregnated Dressings. Biology of Blood and Marrow Transplantation 21(2): S396-S397, 2015

Chlorhexidine gluconate-impregnated central-line dressings and necrosis in complicated skin disorder patients. Journal of Critical Care 29(6): 1130.E1-4, 2014

Staphylococcus aureus bacteraemia associated with peripherally inserted central catheters: the role of chlorhexidine gluconate-impregnated sponge dressings. Medical Journal of Australia 200(6): 317-318, 2014

A randomized trial comparing povidone-iodine to a chlorhexidine gluconate-impregnated dressing for prevention of central venous catheter infections in neonates. Pediatrics 107(6): 1431-1436, 2001

Is 2% chlorhexidine gluconate in 70% isopropyl alcohol more effective at preventing central venous catheter-related infections than routinely used chlorhexidine gluconate solutions: A pilot multicenter randomized trial (ISRCTN2657745)?. American Journal of Infection Control 44(8): 948-949, 2016

Removal of Chlorhexidine Gluconate-Impregnated Dressings Due to Skin Irritation in Patients Under Hematopoietic Stem Cell Transplantation. Biology of Blood and Marrow Transplantation 21(2): S395-S396, 2015

Review: chlorhexidine-impregnated dressings reduce risk of colonisation of central venous catheters and risk of catheter-related bloodstream infection. Evidence-Based Nursing 18(3): 91-91, 2016

Comparative of a new and innovative 2% chlorhexidine gluconate-impregnated cloth with 4% chlorhexidine gluconate as topical antiseptic for preparation of the skin prior to surgery. American Journal of Infection Control 35(2): 89-96, 2007

Intravascular catheter dressings with chlorhexidine-impregnated sponges reduced infections in the ICU. Evidence-BasedNursing12(4):115, 2009

A Different Experience with Two Chlorhexidine Gluconate Dressings for Use on Central Venous Devices. American Journal of Infection Control 41(6): S142-S143, 2013

Suppression of regrowth of normal skin flora under chlorhexidine gluconate dressings applied to chlorhexidine gluconate-prepped skin. American Journal of Infection Control 40(4): 344-348, 2012

Chlorhexidine-impregnated intravascular catheter sponge dressings: an ounce of prevention is worth a pound of cure. Critical Care Medicine 40(1): 296-298, 2012

Chlorhexidine-Impregnated Dressings and Prevention of Catheter-Associated Bloodstream Infections in a Pediatric Intensive Care Unit. Critical Care Nurse 36(6): E1-E7, 2016

Chlorhexidine-impregnated transparent dressings decrease catheter-related infections in hemodialysis patients: a quality improvement project. Journal of Vascular Access 18(2): 103-108, 2017