Managing Adverse Skin Reactions Associated With Central Line Dressings in Children: A Survey of Dermatologists.

Abstract

Central line dressings (CLDs) may be associated with adverse skin reactions in hospitalized children. Currently, standardized protocols to guide the management of cutaneous CLD reactions are unavailable at our children's hospital and in the pediatric literature. We surveyed dermatologists at multiple institutions who routinely perform pediatric consults to assess their management practices and/or the use of standardized protocols for addressing adverse cutaneous reactions to CLDs. All (n = 35) respondents reported receiving CLD-related consults, often involving interdisciplinary teams, yet most (66%) did not have standardized management protocols. When available, reported protocols for the management of CLD-associated skin reactions differed, including variable inclusion of chlorhexidine gluconate within polyurethane dressings and the use of patch testing for allergies or irritant reactions to applied products. Our findings support the need to further clarify patient and agent-specific factors predisposing to CLD-associated skin reactions and to develop and validate a multicenter protocol to optimize the management of CLD-associated skin reactions.