Pediatric home-based central venous access device dressings: Medical liquid adhesive versus standard care to reduce...

Central venous access devices (CVADs) are frequently used in Hospital-At-Home models to facilitate prolonged intravenous treatment for children. Premature CVAD dressing disruption is common and contributes to device failure. This protocol describes a trial evaluating the adjunctive use of medical liquid adhesive at the dressing-skin interface to improve dressing adhesion and maintain dressing integrity.

This single-site, two-arm, parallel-group, superiority randomized controlled trial undertaken in a children's Hospital-at-Home will evaluate whether adding medical liquid adhesive to standard CVAD dressings, compared with standard dressing alone, reduces dressing disruption. Children aged ≤18 years requiring a CVAD for ≥7 days will be randomized 1:1 to standard dressing plus medical liquid adhesive or standard dressing alone. Dressing integrity will be assessed daily, with dressing-related outcomes assessed after 7 days or following dressing change (whichever occurs first). At each dressing change, participants are eligible for repeat participation, retaining their original randomization. The primary outcome is dressing disruption requiring premature replacement or reinforcement before the scheduled 7-day change. Secondary dressing-related outcomes include dressing dwell-time, skin adverse events, CVAD complications, patient, caregiver, and clinician satisfaction. Secondary outcomes assessed once per participant are healthcare utilization and costs. Analyses will follow the intention-to-treat principle.

Ensuring the safety and durability of invasive devices beyond the in-hospital setting is an increasing priority in pediatric care. This trial will provide rigorous data to inform the clinical- and cost-effectiveness of the addition of medical liquid adhesive to standard dressings to improve CVAD dressing integrity, supporting care across the hospital-to-home continuum.