This is topic PICC rash and itching in forum Medical Questions at LymeNet Flash.


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Posted by blinkie (Member # 14470) on :
 
Does anyone have experience with allergy to PICC dressings? I seem to be allergic to them all. Tegaderm, Covaderm, and mepalex. I'm tired of itching all the time.

I don't know how much longer I can stand it.

any suggestions? I can't take benydryl or most allergy meds, anti-histamines make me too sleepy to function.
 
Posted by bigstan (Member # 11699) on :
 
Yes, after your nurse cleans the area around the picc line, have your nurse spray the area with nasonex lightly. Alow to air dry. If you have Bio-Patch put that around the line. Then cover with bandage.

They make sensitive skin bandages which you should ask for.

Nasonex is the trick. Your itch will go away within a few days.
 
Posted by blinkie (Member # 14470) on :
 
I can't use bio=patch...allergic to chloraprep. I'm using the only thing they have for people with sensative skin...mepalex. Do you have the brand names of any sensative skin covers?

My LLMD suggested doaderm but they can't get it and it's not sterile so they won't use it anyway.
 
Posted by Dawn in VA (Member # 9693) on :
 
I too am allergic to chloraprep. Had a nasty itch and rash around my PICC when I had it years ago. Couldn't figure it out until I asked the home health nurse to use alcohol and/or betadine instaed. No more itchies!
 
Posted by soleil16 (Member # 16326) on :
 
I am also allergic to chloraprep, latex and most adhesives. My nurse and I had to come up with a pretty creative solution. I have had this line since October and have used the technique below with no infection or complications:

Instead of using a stat-lock to secure the line, I have had stitches put in on the butterfly part to hold the line to my skin. The stitches came out once in January and are just about out again (skin just works them out) so they've been redone at the hospital, but this is not a big deal compared to the adhesive allergy.

We use alcohol to clean my arm each week. Then, instead of using any kind of tegaderm, etc, we use the cotton pads from the dressing change tray to pad around the stitches. I use a Biopatch also. We wrap my padded arm in a full roll of sterile cotton bandage and then use co-band around that to secure everything.

This can be more difficult to keep clean and sterile between dressing changes. The cotton and co-band can slip a little and require an extra wrapping sometimes so the entry site does not become exposed. I have to be really careful about moisture. My arm is even more delicate because there are stitches.

However, this is the best solution I have found to keep my arm from blistering due to the products normally used. With my first PICC line, I had what the nurse says amounts to second degree burns on my arm. I am so much happier with our new plan.
 
Posted by blinkie (Member # 14470) on :
 
thanks. I can't get the infusion clinic to use anything that isn't sterile. Maybe I'll have to push them a little hards since me LLMD ok'd it.
 
Posted by sammy (Member # 13952) on :
 
Hi blinkie,

I'm also allergic to Tegaderm, most tapes, and adhesives.

Have you tried Sorbaview or IV3000 OpSite dressings? They are supposed to be more hypoallergenic (according to my friend the "wound care specialist").

My favorite dressing is the "IV3000" by Smith and Nephew. It is the only one that doesn't make me itch! I also use their brand skin prep too. It helps protect the skin and makes the dressing adhere better.

I also use an alternative for the stat-lock that is more breathable. It is called "Grip-Lok" Universal Catheter Securement, medium sized. I order it from Infuserve.

If you are allergic to chloraprep and the biopatches you might consider trying Smith and Nephew's "ACTICOAT site". It is an antimicrobial disk like the biopatch but it uses silver instead of chloraprep. I have not tried this product myself but I read about it on their site a couple days ago when I wanted to order a box of dressings. Check it out here: http://global.smith-nephew.com/us/ACTICOAT_SITE_7269.htm

Another thing to consider if you are itching all the time. You might have a yeast infection on your skin. This happened to me last summer. It was terrible. Started out with little red itchy dots then it got more irritated, blisters formed and oozed. I wanted to scratch my arm off! Had to take Diflucan for about 2wks to clear it.

My dermatologist prescribed "Xolegel" (topical antifungal gel) to help prevent the yeast rashes. I apply it after cleansing the skin, let it soak in, then apply the skin prep, grip lock, biopatch, then dressing.

Hang in there blinkie. I hope that your nurses will be willing to help you find the right solution to your itchy problem.
 
Posted by blinkie (Member # 14470) on :
 
sammy-thank you so much! I will look into these dressing options ASAP!

I did treat yeast with two weeks diflucan. It made a big difference but still have the itching and mild bumpy rash.
 
Posted by 2young2die (Member # 25434) on :
 
The OpSite dressing worked much better than the Tagaderm for me. I still get slight rashes along the top of the dressing from it pulling on my skin, so I clip alittle off and put neosporin on the area.
 
Posted by bigstan (Member # 11699) on :
 
Nasonex is the trick. Sounds strange doesn't sound like anyone here has tried it but it works.

You don't need the bio-patch.

Bandages:

* The standard bandage used is called Tegaderm, which is a clear plastic-like bandage. This stuff drove me nuts, and was very irritating to my skin.

* Alternatives are: Opsite (various forms, including IV 3000, Opsite Grid are ok) or Primapore. These are all known to be better for those with sensitive skin. All are under the brand name of Smith & Nephew. Most infusion services will carry the Opsite products. If not, you may want to order a box on your own to save your skin.

* The standard bandage change kits come with a Tegaderm bandage. Be sure to request the kit in addition to the bandage type of your choice, since you do need some of the other stuff in the kit. You should be having the extender line changed at the same time as the bandage change, although you can go for 2 weeks for the extender line change.

* The elastic stretchy bandage covering supplied by the hospital and the infusion service is used to hold the line in place. This stretchy open-weave material can be very itchy as well. For something more soft and comfy try cutting off a tube sock and using that instead.

* Bandage changes (the sticky bandage) should be changed weekly. If you have a nurse or a home nurse helping out, she'll do it for you. If your insurance doesn't cover this forever, then you may want to either learn how to do it on your own, or have someone else learn to do it. It's very easy, but working with sticky stuff can be tricky.

The general rule is that if you have a more stable bandage (Primapore) or a more stable bandage backing material (Opsite Grid), it's easier to handle.

The only issue with Primapore is that it is not as 'sticky' as some of the other materials, so you do have to make sure to stick with your weekly bandage changes or the edges may start to detach from your skin a bit.
 


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