Management of Tape-Related Itching Around Permacath Sites in Dialysis Patients

Immediate Management Strategy

• The National Kidney Foundation recommends switching dressing materials immediately to replace micropore tape with hypoallergenic alternatives or use sterile transparent semi-permeable dressings that minimize direct tape contact with skin 1
• The American Journal of Kidney Diseases suggests using dry gauze dressings instead of transparent film if the patient has ongoing skin irritation, as gauze can be secured with less adhesive contact 2, 3, 4

Skin Protection Protocol

• The International Journal of Infectious Diseases recommends applying skin barrier films or protective wipes to intact skin before tape application to create a protective layer between adhesive and skin 5
• The Clinical Infectious Diseases journal suggests replacing dressings when they become damp, loosened, or visibly soiled to minimize prolonged adhesive contact 1
• The Clinical Infectious Diseases journal also recommends using chlorhexidine-impregnated sponge dressings as an alternative that may reduce both infection risk and the need for extensive tape 1

Common Pitfalls to Avoid

• The American Journal of Kidney Diseases warns against using topical antibiotic ointments on the irritated skin around the exit site, as guidelines recommend against this except for specific dialysis catheter protocols 1
• The American Journal of Kidney Diseases also warns against applying glycol-containing ointments if the catheter is polyurethane, as certain manufacturers contraindicate this 2, 3, 4

Monitoring and Follow-up

• The Clinical Infectious Diseases journal recommends assessing the skin at each dressing change for improvement in erythema, scaling, and patient-reported itch 1
• The American Journal of Kidney Diseases emphasizes the importance of ensuring staff are adequately trained in catheter dressing changes, as infection rates and complications increase with inadequately trained personnel 2, 3, 4