The Effect of Central Venous Catheter Dressings on Preventing Catheter-Related Bloodstream Infections: A Comparative Study of Patients in Intensive Care Post Abdominal Surgery

Aim: To evaluate the incidence of catheter-related bloodstream infections and the safety characteristics of chlorhexidine gluconate (CHG)-impregnated transparent dressings compared with standard transparent dressings in patients monitored in the intensive care unit post abdominal surgery. Methods: A total of 102 patients who had a central venous catheter inserted via the internal jugular or subclavian vein and for whom the catheters were expected to remain in place for ≥48 hours were included in the study. Patients with disrupted skin integrity, known allergies to dressing components, or pre-existing bloodstream infections prior to catheterization were excluded. Patients were randomly assigned in a 1:1 ratio to either the CHG-impregnated transparent polyurethane dressing group (n=51) or the standard transparent dressing group (n=51). According to the protocol, dressings were replaced every seven days in the CHG group and every 2-3 days in the standard group, or as clinically necessary. The primary discontinuation was defined as the development of catheter-related bloodstream infections. Categorical variables were analyzed using the chi-square/Fisher test, while independent risk factors were evaluated using logistic regression (p<0.05). Results: The groups were similar in terms of age, gender, catheterization duration, and intensive care duration. The catheter-related bloodstream infection rate was 5.9% (3/51) in the CHG group and 25.5% (13/51) in the standard group, and the difference was statistically significant (p=0.014); the absolute risk reduction was 19.6%. Multivariate analysis demonstrated that standard dressing use was an independent and strong risk factor for catheter-related bloodstream infection (OR: 21.2; 95% CI: 2.5-177.1; p=0.005). Each additional day of catheterization increased the risk of infection (OR: 1.2 (1.1-1.3); p=0.002 ), and female gender showed an independent association (OR: 8.1 (1.5-44.6); p=0.016). Skin reactions were found in 5.9% (3/51) of the CHG group and 27.5% (14/51) of the standard dressing group, with a significant difference between the groups (p=0.037). Reaction severity was found to be significantly lower in the CHG group (p=0.045). Major complications and dressing intolerance were observed only in the standard dressing group (3.9%), while no such complications were observed in the CHG group (p=0.010). Conclusion: The routine inclusion of CHG-impregnated transparent dressings in central venous catheter care protocols in intensive care units is considered a powerful strategy that can contribute to reducing the incidence of catheter-related bloodstream infections, improving patient safety, and managing care processes more effectively.