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Restriction of bacterial growth under commercial catheter dressings
1Department of Dermatology, University of California, San Francisco 94143.
Abstract:
The effect on the normal cutaneous flora after iodine and alcohol disinfection of the skin of three commercially available moisture-permeable polyurethane dressings was compared with that of a gauze-and-tape dressing. Dressings also were evaluated clinically for membrane adhesion and skin erythema, pruritus, hyperpigmentation, vesiculitis, and tenderness. Each of 50 healthy volunteers and 49 long-term inpatients, 25 of whom were receiving antibiotic therapy, received simultaneously on their volar forearm patches of Op-Site, Tegaderm, Uniflex, and gauze dressings. Controls consisted of one exposed skin site and one covered with moisture-retaining vinylidene film (Saran Wrap). Although after 3 days of adhesion, commercial dressings prevented indigenous flora from returning to normal population densities, no significant quantitative differences were found between them and the gauze-and-tape dressing. Generally, all clinical dressings maintained normal flora at one tenth the population of the uncovered site; the Saran Wrap control supported 100-fold more bacteria than the exposed site. No differences were discovered in the levels of gram-negative bacteria, or among patient groups and between patients and healthy subjects, except for the lower incidence of erythema and itching among patients compared with healthy subjects.
Insights
Modern wound dressings like Op-Site, Tegaderm, and Uniflex did not significantly alter skin flora compared to traditional gauze. All dressings maintained normal flora levels, with no significant differences observed between dressing types or patient groups.
Area of Science:
- Dermatology
- Microbiology
- Wound Care
Background:
- Cutaneous flora plays a crucial role in skin health.
- Effective wound dressings are essential for maintaining skin integrity and preventing infection.
- Assessing the impact of advanced dressings on skin microflora is important for clinical practice.
Purpose of the Study:
- To compare the effects of polyurethane dressings (Op-Site, Tegaderm, Uniflex) and gauze on normal cutaneous flora.
- To clinically evaluate these dressings for adhesion and adverse skin reactions.
- To assess differences in flora and clinical outcomes between healthy volunteers and inpatients, including those on antibiotics.
Main Methods:
- Three moisture-permeable polyurethane dressings and a gauze-and-tape dressing were applied to the forearms of healthy volunteers and inpatients.
- Skin flora populations were quantified after 3 days of dressing adhesion.
- Clinical assessments included membrane adhesion, erythema, pruritus, hyperpigmentation, vesiculitis, and tenderness.
Main Results:
- All tested dressings, including polyurethane and gauze, prevented indigenous flora from returning to normal densities after 3 days.
- No significant quantitative differences in flora were found between the commercial dressings and the gauze-and-tape dressing.
- All clinical dressings maintained flora at one-tenth the population of uncovered sites; vinylidene film (Saran Wrap) supported significantly higher bacterial growth.
Conclusions:
- Commercially available moisture-permeable polyurethane dressings and traditional gauze dressings have comparable effects on normal cutaneous flora.
- These dressings effectively control bacterial populations on the skin.
- Patients, particularly those on antibiotics, showed a lower incidence of erythema and itching compared to healthy subjects, suggesting potential benefits or altered responses in this group.