Central Line Dressing Change Frequency Recommendations
For central venous catheters, gauze dressings should be changed every 2 days and transparent dressings every 7 days. 1
Detailed Recommendations by Dressing Type
Transparent Dressings
- Change transparent dressings on central venous catheters every 7 days for short-term catheters 1
- Transparent dressings allow continuous visual inspection of the insertion site and require less frequent changes 1
- In a randomized controlled trial, extending dressing changes from every 3 days to every 7 days was found to be non-inferior regarding catheter colonization rates (7.8% vs 8.6%) 2
Gauze Dressings
- Change gauze dressings every 2 days on central venous catheters 1
- Gauze dressings are preferable if the catheter site is bleeding or oozing 1
Special Circumstances Requiring Immediate Dressing Change
Regardless of the scheduled interval, dressings must be changed immediately when:
- The dressing becomes damp, loosened, or soiled 1
- Inspection of the site is necessary 1
- The catheter is replaced 1
Impact of Dressing Disruption on Infection Risk
- Dressing disruption is a major risk factor for catheter-related infections 3
- The risk of major catheter-related infection increases more than three-fold after the second dressing disruption 3
- The risk increases more than ten-fold if the final dressing becomes disrupted 3
Considerations for Special Populations
Pediatric Patients
- For tunneled central venous catheters with well-healed exit sites in children, it is useful to have catheters looped and covered 1
- In neonates, a randomized controlled trial found that regular weekly dressing changes resulted in lower catheter-related bloodstream infection rates compared to changing dressings only when oozing was visible (0‰ vs 2.0‰) 4
Tunneled Catheters
- After the healing period (approximately 3 weeks), it remains unclear if a dressing is necessary for tunneled catheters 1
- For well-healed exit sites of tunneled catheters, some evidence suggests dressings may not be required 1
Common Pitfalls and Caveats
- Frequent dressing changes may cause skin damage, which can compromise the skin's protective barrier against infection 5
- Dressings that are bulky and prevent visualization of the insertion site should be removed for daily inspection 1
- In diaphoretic patients, dressings may need to be changed more frequently 1
- Cost considerations: Dressing cost (especially staff cost) is inversely related to the rate of disruption 3
Additional Infection Prevention Measures
- Consider chlorhexidine-impregnated dressings in patients older than two months with short-term catheters who are at high risk for infection 1, 2
- Topical antimicrobial treatment at the insertion site should not be routinely used as it may promote fungal infection, antimicrobial resistance, and damage the catheter surface 1