Cathéters et évolution des modalités d’asepsie cutanée

« Catheter-related infections (CRIs) are common, lifethreatening healthcare-associated infections in intensive care unit (ICU) patients. Accumulating evidence suggests that the incidence of these infections can be decreased through discrete processes of care (Table 1) [1]. Because microorganisms from the skin at the site of catheter insertion are often the source of CRI [2], optimal skin preparation prior to short-term catheter placement is an example of such a discrete process.

Table 1 Basic bundle to prevent catheter-related infection :
-Use written protocol for catheter insertion and maintenance
-Rub hands with alcohol-based solutions before each line manipulation
-Respect full-barrier precaution at catheter insertion
-Cleanse the skin with a 2 % chlorhexidine/70 % isopropyl alcohol sterile
solution
-Select subclavian vein as preferred access in the absence of contraindications *
-Change non-adherent, soiled, or moistened dressing
-Remove catheters that are clinically no longer necessary

In conclusion, use of sterile 2 % CHG/70 % isopropyl alcohol for skin antisepsis should be included in all bundles for intravascular short-term catheter-related infection prevention. Cleansing the skin with an antiseptic detergent before skin antiseptic application can no longer be recommended. »


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Dernière mise à jour : 10/11/2016

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