How to deal with the case sharing of allergies after PICC surgery

Foreword: Chemotherapy is an essential means of clinically treating tumors. The application of PICC can make the drug enter the body circulation quickly, can reduce the tissue damage caused by drug extravasation, and provide a safe, efficient and convenient way for tumor patients. the treatment route. However, some patients may experience local skin reactions (contact dermatitis) under the transparent dressing of the limb on the side of catheter placement due to their allergic constitution to material allergy and unstable internal environment after radiotherapy and chemotherapy after catheter placement. Improper handling can lead to infection at the site of catheterization or catheter infection in severe cases, which may even threaten the patient's life.

Let's take a look at a set of clinical cases:

A female patient, 29 years old, with a lymphatic tumor, required a PICC catheter to be placed in the right upper extremity in another hospital due to her illness. She came to the hospital for catheter maintenance on June 8, 2020, while the patient was at home. She complained of itchy skin on the part of the dressing. After the dressing was removed, the patient's skin showed redness at the place where the transparent dressing was attached, scattered rashes with exudation, and a small amount of yellow purulent exudate at the puncture point. The hospital's final treatment method: wipe and clean the local skin with normal saline, disinfect with iodophor, infiltrate gauze with 100 ml of normal saline + 5 mg of dexamethasone to cover the rash for 30 minutes, and apply dexamethasone ointment after it is fully dry to avoid puncture. Point. Use sterile gauze to cover the wrap and fix it with an elastic bandage. Afterward, the patient's skin improved significantly, the puncture point was dry, and the patient complained of minor itching.

How do you avoid such problems, and how do you deal with them?

Why exactly did the skin at the patient's PICC catheter have such problems? When the patient's skin has allergies, how should we take care of it? With these questions, we begin the following analysis.

Causes of PICC allergic dermatitis?

There are many reasons for the occurrence of local allergic dermatitis after PICC catheterization, which are mainly divided into external factors and internal factors. The internal factors are primarily the patient's special allergic constitution, such as the patient's allergy to disinfectants and the patient's skin sweating easily. Itching occurs between the catheter and the catheter, and some patients are allergic to the transparent applicator due to their allergy-prone constitution. External factors mainly include physical stimulation caused by cleaning and wiping, the stimulation of transparent applicators with poor ventilation, the stimulation of disinfectants such as iodophor and alcohol, and the reduction of patient immunity by surgery.

For patients who are allergic to transparent dressings, which dressing should we choose for fixation?

Alginate dressings and self-adhesive elastic bandages are recommended for people with sensitive skin, especially the elderly and children.

Longterm Medical Alginate Dressing: Made from a natural material derived from seaweed, it is a highly absorbable and biodegradable dressing. Its main ingredient is calcium alginate, which is a water-insoluble substance. When it encounters liquids rich in sodium ions (such as exudate and blood), calcium and sodium ions will be exchanged, calcium ions will be released, and sodium ions will combine with alginic acid to form a hydrophilic gel. Substances that help the wound maintain a moist environment and enhance autolytic debridement, as well as promote the growth of granulation tissue. Alginate has a strong liquid absorption capacity and can absorb up to 20 times its weight in liquid. Therefore, alginate dressings can be used on moderately to severely exuding wounds, accelerated debridement on wounds with necrotic tissue, and even on infected wounds.

Longterm Medical self-adhesive elastic bandage: It is often not necessary to stick adhesive tape for fixation. It will not affect the elastic bandage when exposed to cold or heat. It has strong elasticity and is very convenient to use, thereby reducing the use of transparent film infection for sensitive skin people. Risks of. It also improves the work efficiency of nurses and fundamentally improves the satisfaction of patients with PICC puncture.

Health education | dietary advice for patients:

Nurses ask patients about allergy history when they are admitted to the hospital and do an excellent job of publicizing and educating patients so that patients know the importance of PICC tube maintenance, improve compliance, and make PICC really brings convenience to patients not trouble.

Instruct the patient to eat more green vegetables or fruits during the diet, and avoid eating bamboo shoots, leeks, and mangoes, which are easily allergenic.

Longterm Medical is a leading company in the industry, with advanced and complete production equipment and inspection systems, as well as a complete set of scientific and sound management systems. At Longterm Medical, we transform this data by innovating and developing products that make life easier for people with caring needs.

For more information on Innomed® dressings, refer to the previous articles. If you have customized needs, you are welcome to contact us; we will serve you wholeheartedly.

At Longterm Medical, we transform this data by innovating and developing products that make life easier for those who need loving care.

references:

1. An Ying, Xie Yali, Feng Guoqin. Effect of alginate dressing combined with an elastic bandage on the puncture point after PICC [J]. Shanghai Nursing, 2020, 20(3):3.

2. Tao Yong, Xue Mei, Mao Jingyu, et al. Effects of chlorhexidine alcohol and povidone-iodine on allergic dermatitis and catheter-related infection during PICC indwelling [J]. Shanghai Nursing, 2019, 19(2): 37-40.

3. Yu Ximei, Ren Yan, Bai Jiangping, et al. Application effect of dexamethasone ointment and gauze dressing in the treatment of severe allergic dermatitis associated with PICC catheter in tumor patients [J]. General Nursing, 2014(27): 2497–2499.

4. Chen Mei, Lu Jianying. Nursing experience of a case of severe PICC catheter-related skin allergic reaction [J]. Electronic Journal of Practical Clinical Nursing, 2018,3(40):21+24.

5. Xu Li. Nursing care of a case of severe skin allergic reaction after PICC intubation [J]. Contemporary Nurses (Mid-Term), 2018,25(05):126-128.

6. Chinese Journal of Modern Nursing

Editor: kiki Jia

Date: July 15, 2022