Tegaderm made me blister so switched to opsite....now that is driving me insane...plus the clamp on the picc itself is blistering my skin where it sits......feel like ripping the whole thing off today.....
need help with other suggestions......another 4 months of this at least need to find something tolerable........
[ 05-21-2011, 07:03 AM: Message edited by: Florence1 ]
Posted by marypart (Member # 27012) on :
Florence, I'm going to PM you, but there was a recent thread you can look at. I'll post it when I find it. Mary
Posted by sammy (Member # 13952) on :
Have you tried the Sorbaview and the Mepore Film dressings?
You may need to switch to a gauze dressing (like Primapore) for a week or two to let your skin heal before you try another transparent dressing.
When you do the dressing changes make sure that you are allowing enough time for the chloraprep cleanser to dry (like several minutes).
After cleansing the site are you using a skin prep to help the dressing stick and protect the skin from adhesive stripping? This is an important step. There are several brands of skin prep, my favorite is the Smith and Nephew "No Sting" Skin Prep. Make sure to allow several minutes for this to dry before applying the Statlock and dressing.
Also, you need to make sure that you are wearing a breathable PICC cover. If your arm gets too warm moisture will collect under the dressing and you will get a rash (and possibly a yeast infection).
My favorite PICC cover is "Tubifast" by Molnlycke. It is a super soft, breathable, stretchy tubular bandage. It comes in a big roll that you can cut however long you want it to be.
I actually use two pieces. Before I figured this out I was also getting blisters wherever the clamps or endcaps touched my skin. So I pull one tubifast layer up over the dressing (leaving the PICC legs and clamps out). Then I use the second piece to tuck up and hold the PICC legs. This protects my skin and keeps everything covered.
If you need to order supplies, I purchased the Tubifast (Blue Line size) and the Mepore film dressings from Allegro Medical Supplies.
Also, your mailbox is full, so I couldn't send you my instructions. Mary
Posted by Florence1 (Member # 22960) on :
mary ill clear my inbox....if you could please send....sorry about that...
Sammy....thanks for the info, I also read the link Mary put on here for me and your post there was a great help.........
Posted by LuLuFlorida (Member # 12066) on :
I am so sorry you are going through this. I have had the same issues. I thought it was the dressing at first but then found out that I was allergic to chloraprep. I switched to pvp dressing.
My problem got better but overtime I got a rash from the leaders with gauze and posited dressings. I found out that the tegaderm 1621 with label works fine. The material is thinner than most tegaderms so it breathes.
This enables any liquid buildup underneath to dry out. If you nurse is not allowing the chloraprep to dry it will make any sensitivity worse. Hot weather and humidity will have this same affect so stay indoors as much as you can. Hot showers or baths have the same effect.
Good luck with this. It took me too long to find a solution that worked for me.
Take care,
Lindsay
Posted by Florence1 (Member # 22960) on :
I am just wondering why it would get worse over the week since dressing change then feels a little better until next dressing change......change monday, peaks thursday/friday..then slightly better until change monday.....any ideas????
Posted by sammy (Member # 13952) on :
What does your skin look like right now? Do you have a few large blisters, some open or weepy? Do you have a rash that looks like poison ivy (red raised bumps that ooz yellow fluid)? Or does it look like a babies diaper rash?
Does the rash extend beyond the borders of your dressing?
How does your skin feel? What happens when you change the dressing? Does benadryl or ibuprofen help?
Let me know what you think, you may be dealing with both an allergy and a yeast infection.
Posted by Florence1 (Member # 22960) on :
nothing beyond the borders....only when the dressing peels back slightly then there has been a blister.......
dressing changes feel like a weird painful relief if that makes sense then the chloraprep makes the skin feel relief because its cold but stinging at the same time........
to be honest doesnt look like much of anything through the dressing except red streaks where the dressing adheres to the skin and some red areas but no obvious blistering through the dressing........
and when the dressing is removed.....no blistering but i feel if the dressing was off long enough it would be obviously reddened underneath..and look more like its been burned....like sunburn...
the main thing is the feeling of intense heat and itching, and its all over the dressing area...I just want to rip it off....
ive never had it taken off at its worst.....perhaps i should have the nurse come back when its really bad and see whats underneath....and leave it off for a little longer.......
Posted by marypart (Member # 27012) on :
Florence,
My son's started out with itchiness and redness. Over the next week or two it got bumpy, then infected and they had to pull the line.'
With the next picc we only used gauze, held on with a pressure bandage. No tapes, no plastic, no glues. Much better and beautiful skin and comfortable.
Did you get my PM? mary
Posted by Florence1 (Member # 22960) on :
yes mary thanks..........just trying to figure out what the issue is......
Posted by sammy (Member # 13952) on :
Ok, that doesn't sound like yeast. You would have an obvious rash that is only getting worse and it would spread beyond the borders of the dressing.
So you don't have any blisters except when the dressing corner gets rolled back? That might not be an allergy at all. That can happen if the dressing edges pull at the skin. If the dressing gets stretched at all as it is applied this can happen. Ask whoever puts the dressing on to gently lay it on your skin, to be careful not to pull it tight.
You may also be experiencing some skin stripping when the dressing is removed. Try using an adhesive remover to take off the dressing without pulling on your skin. Then apply two layers of skin prep to protect your skin before the dressing is applied.
These are easy fixes, hope they help you.
Posted by Florence1 (Member # 22960) on :
sammy why is it so darn hot and itchy??......you dont think it could be the chloraprep??? or any other suggestions....
the skin prep you mentioned is that the usual one that comes in a dressing kit....or something specific?? ....
seems like evn paper tape is leaving more of a mark......could it be the antibiotics somehow causing skin to be more reactive??
also did you get my pm about the tubifast??
Posted by sammy (Member # 13952) on :
Why is it hot and itchy? Maybe because it is irritated and trying to heal. It may also be due to the type of cover you are using. You should try the Tubifast. It is much easier on the skin than anything else I've found.
Does skin prep come in the dressing change kit? Possibly. That will vary depending on where you get the kit. Look on the label of the kit, there will be a list of contents. Remember Cloraprep is the skin cleanser. Skin prep may also be called something like "skin protective wipes".
Paper tape can leave a red mark when it is pulled off sensitive skin. It may help to use skin prep before applying any tape or dressing and adhesive remover to prevent skin stripping.
If these things don't help you could try switching to a gauze dressing. Be aware though that gauze dressings need to be changed every 48hrs, transparent dressings can remain in place up to 7 days.
Posted by lindaca (Member # 23871) on :
Primapore is the easiest on the skin. It's a cloth-like material instead of the saran-wrap stuff. I have very sensitive skin, and have had zero issues with it after 1+ year of use. The Tegaderm was a total nightmare.
The Primapore also has a built-in gauze pad, which helps to reduce the amount of skin surface that the adhesive is touching.
Also, if the regular stretchy/elastic stuff that the hospitals and infusion services supply is irritating, use a cut-off tube sock instead - it's much softer and non-irritating.
Posted by racer (Member # 30438) on :
My child's PICC issues are finally clearing up. He finally allowed us to put on a tegaderm today, after a month of gauze banadaging.
The skin-prep is put on after cleaning to protect skin - one brand I heard is good is called Cavilon. We are trying it now.
I think my kids' issue was yeast.
We also did a skin test with a small piece of tegaderm on the other arm... with half chloroprep, half nothing under it. No issues - so we are going back to tegaderm ( I hope).
It is ok to use gauze bandage for a while - but they do need to be changed more frequently as sammy said, since the site cannot be observed/monitored.
good luck, racer
Posted by racer (Member # 30438) on :
Followup - my child is allergic to chloraprep. It was not a yeast problem.
Watch out the antimicrobial patch (disk) used at insertion site. The BioPatch has chloraprep in it, but the Kendall disk does not.
One way to test is to put a small amount of chloraprep somewhere else on the body and cover with small piece of tegaderm. Do the same w/o chloraprep (to see if it is tegaderm).
racer
Posted by samsy (Member # 6518) on :
I was allergic to every dressing the nursing agent tried, and they tried everything. Eventually lost a PICC line because the skin breakdown from the dressings was so bad. Since then, I had another surgery which required a dressing. The Mepore film is the only thing I can tolerate. How about placing another Mepore dressing below the PICC where the tubing lies against your skin?
Posted by lindaca (Member # 23871) on :
For me it was the Tegaderm. I've had a PICC for over a year now, using just the Primapore bandages, and my skin is perfectly clear underneath.
Posted by Florence1 (Member # 22960) on :
ok so since january tried tegaderm...blistered....
moved to opsite.....lasted about 3 weeks started to redden we thought maybe the chloraprep so we stopped that.......the reddening continued until it was really inflammed and red, super hot and itchy.....that was about...3 weeks or so....
we switched to IV3000.....same no chloraprep......using flonase spray seemed to do the trick for about 5 weeks then started to get itchy and red over maybe 2-3 weeks...we kept moving the dressing around so not to put it on the extra reddened areas........
now the whole thig is really inflammed bright red, very sore, itchy, hot......no we have nowhere to go.......
now I am so down about it i have at least until august to go.....
I think at this point i can try primapore or a regular gauze to calm it down....I am taking benadryl around the clock and hydrocortisone on the now exposed horrendous areas (i know steroids and all but honestly it is so bad )....
i know some of you had pm'd me a while back so i am going to review those.......but any other suggestions would be greatly appreciated.......
Posted by racer (Member # 30438) on :
It may take a while to calm down, even if you have removed the allergen (if it is an allergy). I heard of another person who could not use either Chloraprep or PVP - I think he uses just alcohol (not good if you have broken skin/rash - ouch).
We followed the advice on using the gauze - not as good for kids, since the PICC will not be as secure, but you can wrap it under/over to help secure it better.
Also, if you have a chloraprep allergy and are using the bio-patch, it also has Chloraprep in it. Use the Kendall disk instead.
Good luck, racer
Posted by Florence1 (Member # 22960) on :
thanks racer....its not chloraprep because under the biopatch is good...and i think because the dressing doesnt touch the skin there.....and we stopped the chloraprep cleaning about 8 weeks ago.....
funny though because the alcohol is a strange sense of relief....it hurts but because its cool it feels good at the same time.......
Posted by sammy (Member # 13952) on :
If your arm feels hot and itchy you can use an icepack for relief. Cover it with a towel so that it doesn't sweat on your arm. Leave it in place for 20-30min.
Are you using alcohol as your cleanser instead of chloraprep or providone iodine? If your skin is irritated alcohol will make it worse (it can damage the cells and slows healing).
If your skin is irritated and raw feeling you could try using Hibiclens as your cleanser. It is very gentle, it will not burn. Hibiclens is 4% CHG + detergent, Chloraprep is 2% CHG + 70% isopropyl alcohol.
Your nurse would apply the Hibiclens with sterile gauze 4x4's. Let the Hibiclens dry. Then use saline on gauze 4x4's to remove the Hibiclens. Once the site is dry, apply your biopatch and dressing.
The primapore dressings are breathable and will allow your skin to heal. If you don't want to use primapore you could cover the site with a 4x4 sterile non-stick dressing, hold in place with rolled gauze then coban.
Once your skin is completely healed you can try switching back to the chloraprep and transparent dressings. It might be smart to test them on your arm for a couple days before you put them over the picc site.
Good luck Posted by sleeping dog (Member # 27267) on :
i had problems with the clear dressing...itching, burning, and very raw, painful skin. after trial and error, i now only use fabric dressing with fabric tape. no more clear bandages and tapes. the pain, itch, and rash are gone, the only issue is that the fabric doesn't adhere well to my skin. i need to re-tape daily and change my bandage two or three times a week (the nurse leaves a few extra with me). the bandages literally fall off my arm... good luck! it is a non-issue for me now.
Posted by Florence1 (Member # 22960) on :
ok so finally we had to switch to gauze....skin is so raw..the whole area now where any clear dressing has ever touched my skin......
we now have gauze.....we tried coban but that reacted to my skin now we have gauze, gauze bandage and coban over the top but there is nothing holding it to my arm as the gauze is the only thing against my skin....even paper tape to hold the gauze that has always been ok is reddening.....
its as though my skin has just had it with everything.......yesterday we talked about moving the picc to the other arm....my skin will start to break down soon......
my nurse said she has seen skin irritation but nothing like this.....
i am trying to get through to friday...see what the skin looks like then make a decision......my skin is done done done..........
Posted by racer (Member # 30438) on :
Oh poor Florence! I hope your skin gets a chance to heal using the gauze.
Hang in there.
Posted by Florence1 (Member # 22960) on :
Thanks racer....
Posted by sammy (Member # 13952) on :
Florence, if your skin is that raw you may only see a little improvement by friday. It could take a couple weeks to completely heal.
Sleeping dog, have you tried using a skin prep like Cavilon? It helps the dressings stick better and protects your skin from adhesive stripping. You can order it online or from your local pharmacy (got mine at CVS). It's important that your dressing remains intact.
Posted by 2young2dieMom (Member # 25434) on :
Opsite v3000 worked for me. Don't use barrier film or alcohol for cleaning, just betadine.
Posted by Florence1 (Member # 22960) on :
sammy we decided friday because my skin is so raw we could switch to the other arm if necessary....i have to email my LLMD IV nurses some pictures......
2young2diemom.....we have tried IV3000 was ok for a few weeks then broke down again......any adhesive product is making my raw and blistered hence the gauze.......but the gauze doesnt feel secure.........
Posted by lindaca (Member # 23871) on :
Use Primapore, it's a soft gauze-like bandage with a built in gauze pad, so not as much of your skin is exposed to the adhesive. Must change these weekly, as they aren't quite as sticky as the clear bandages, but much much easier on the skin!
![[Smile]](smile.gif)