Are occlusive dressings effective for preventing central line infections?

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Webster J, et al. Gauze and tape and transparent polyurethane dressings for central venous catheters. Cochrane Database Syst Rev. 2011 Nov 9;(11):CD003827.
Reviewed six studies; “four compared gauze and tape with transparent polyurethane dressings (total participants – 33) and two compared different transparent polyurethane dressings (total participants = 126).” A four-fold increase in CLABSIs was found with polyurethane dressings. However, because of a risk of bias and wide confidence intervals the “true effect could be as small as 2% or as high as 17-fold.”

McCann M, Moore ZE. Interventions for preventing infectious complications in haemodialysis patients with central venous catheters. Cochrane Database Syst Rev. 2010 Jan 20;(1):CD006894.
Includes review of one study (n=58) on use of polyurethane transparent dressings and gauze in hemodialysis patients. There was no statistically significant difference in incidence of central line site infection or central-line associated bacteremia between gauze and polyurethane.

Gillies D, et al. Central venous catheter dressings: a systematic review. J Adv Nurs. 2003 Dec;44(6):623-32.
Searched Cochrane databases, Medline, CINAHL, and CancerLit.  Identified and reviewed 8 studies that evaluate various dressings in the incidence of CVC-related infection and in catheter-related sepsis in hospitalized patients.
RESULTS: Studies included comparison of gauze/tape v. Opsite IV 3000; Opsite v. Opsite IV 3000; Tegaderm v. Opsite IV 3000; Tegaderm v. Opsite.
In the 6 studies with pooled data, odds ratios did not favor either group for incidence of infection. Review was limited in that all studies had small populations.
See Table 4 for summary of meta-analysis.

Hoffman K, et al. Transparent polyurethane film as an intravenous catheter dressing. A meta-analysis of the infection risks. JAMA. 1992 Apr 15;267(15):2072-6
This is a systematic review of 7 studies, but a couple of the studies compared gauze plus a topical antiseptic preparation to occlusive dressing without the topical.

Reviewed and updated 4/24/2014 ldt

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