PICC lines + IV therapy

The only rash I get at my PICC location is a pressure rash from the spandage holding the lines close to my skin. Manifests as a patch of very, very dry & flaky skin.

Are you allergic to the tegederm dressing cover? Might need to try alternatives.

Are you allergic to the betadine or chloroprep used to sterilize the area during dressing changes? Might need to consider switching to something else...

And there is the option to do daily/alternate day dressing changes and use gauze only instead of the more water-resistant covers...thus enabling more air circulation to the site.

Have you tried skin prep? Or some people use zinc oxide cream instead of skin prep...

Another alternative is to have a port implanted in your chest (and get the PICC removed). There is no need for a dressing, as you poke through the skin with a special needle to access the port.

I have had a picc for about a year and I have not had any issues with it. I do the daily infusions, there is and extender placed on the end. I don't do any dressing changes, but I have a nurse come weekly. She does vitals and draws bloodwork for cbc and a metabolic panel. We discuss how I'm doing and she does the entire dressing change.

She has told me that she has seen picc really mismanaged not on the patient's side but the infusion company. Let me know if you have any more questions.

Good Luck!

Traveler,

That is a great article lots for all to learn!

They initially had me on the Tegaderm patch, but when I started breaking out they switched me to the IV3000. I've been on that for maybe three weeks now and I've steadily gotten worse. They've been using skin prep on me as well. I suppose I could be allergic to the chlorahexadine they use, but that's definitely not the only problem. The rash I have has started to spread onto my ribcage, as well as my right hand and arm. I've picked up an antifungal cream in hopes that I can at least keep it contained for now.

I definitely feel like the majority of my current situation is a result of negligence on my nurse's part. It's very frustrating, because I'm not a trained expert on all of this and I'm still learning the standard protocol for care. SHE is supposed to make sure everything's done right. (Your shared outrage at her lack of care warms the cockles of my angry little heart, by the way! ;D)

Cave76, you're absolutely right. We do have the power to ensure that we're getting the care we deserve. I'm realizing that a little too late, and hopefully my issues can serve as a cautionary tale. Don't take chances when it comes to your health, and be assertive!

I've had the dressing changed 3 times in the past 4 days, and it continues to weep and spread the rash. I found one old school trick that helps soothe the skin around the dressing, though: Maalox. The exudate coming from my site is acidic, and the antacid properties of the liquid Maalox help to soothe the 'burned' skin. It's quite nice! haha

I'm getting someone to come out tomorrow to draw labs and do another change. Keep your fingers crossed that no signs of infection show in my labs!!

PS, That was a fantastic resource, Traveler. I'm gleaning a good bit of information from it that I never received! Thanks!!

My daughter has a hickman (non lyme related), so a little different, but I don't think it should be weeping. That sounds suspicious of a site infection (which can quickly get into the bloodstream and cause sepsis). I would get it cultured ASAP if you haven't already. And if you get a fever, head straight to the ED for blood cultures.

For skin sensitive products, I'd look into wound products from Mölnlycke -- their adhesive is water based, so much easier on the skin. They also have some awesome wound products that can absorb the ooze and hold it away from the skin, allowing it to heal (mepilex lite, mepilex transfer). Also cavilon skin preps are great for sensitive skin because they are alcohol free, unlike most other skin preps.

Hope this helps, and good luck!

Hi,
I have had my PICC for just over a month and the rash is now insane.
What are we doing wrong ? I NEED this line. I have late stage lyme. I desperately need to keep this line.

I use Sorbaview and Statlock. So many people are allergic to Tagaderm I just told them I was allergic to avoid that battle. But having bad rash anyway.

We put on non sterile gloves, use adhesive remover pads to get the dressing and Statlock off.

Then we go sterile with masks , new sterile gloves, and sterile drapes.

Then cleanse with 3 alcohol swabs. Dry. Then 3 chlorhexidine swabs. Dry.

Then apply disk (not Biopatch) that is impregnated with silver (Silveron ? )

Then apply statlock and sorbaview.

What should I try ? Anybody found any good alternatives ? Have people been able to keep lines clean using the daily gauze pad and wrapping routine ?

Any help appreciated.