0 Preventing complications: When sterile gloves are necessary - brnskll.com

Preventing complications: When sterile gloves are necessary

Preventing Complications of Central Venous Catheterization — NEJM.

Two kernels of useful detail to the body artist can be found in this article.

First, clear evidence that sterile-barrier precautions make a measured difference in reducing the rate of infections.

INSERTION TECHNIQUE

Preparation

When inserting a catheter, one should use maximal sterile-barrier precautions, including a mask, a cap, a sterile gown, sterile gloves, and a large sterile drape. This approach has been shown to reduce the rate of catheter-related bloodstream infections and to save an estimated $167 per catheter inserted.14 The use of chlorhexidine-based solutions for skin preparation may be preferable to the use of povidone–iodine solutions, because chlorhexidine reduces the risk of catheter colonization.35,36 A video that shows the insertion of catheters at the internal jugular and subclavian sites is available with the full text of the article at http://www.nejm.org.

This is one of many procedures where the importance of sterile gloves and the appropriate sterile barriers is shown. Clearly, body art procedures are less extreme, and the level of exposure should not be as great as entering major blood vessels during a piercing, tattoo or mod procedure. Body art procedures benefit from a subset of these precautions. In particular, a mask and sterile gloves along with antiseptic skin preparation minimize the risks involved in creating a wound for the sake of body art.

Second, evidence why antibiotic ointments are contraindicated for aftercare.

MAINTENANCE OF THE INSERTION SITE

Ointments, Subcutaneous Cuffs, and Dressings

Application of antibiotic ointments (e.g., bacitracin, mupirocin, neomycin, and polymyxin) to catheter-insertion sites increases the rate of catheter colonization by fungi,15 promotes the emergence of antibiotic-resistant bacteria,16 and has not been shown to lower the rate of catheter-related bloodstream infections.17 These ointments should not be used.44 Likewise, the use of silver-impregnated subcutaneous cuffs has not been shown to reduce the incidence of catheter-related bloodstream infections and therefore is not recommended.15,45,46 Because there are conflicting data on the optimal type of dressing (gauze vs. transparent material)47,48 and the optimal frequency of dressing changes,49,50 evidence-based recommendations cannot be made.

Although the evidence on what kind of sterile dressing is conflicting, we remain open to both gauze and transparent dressings as a sterile barrier during aftercare.

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