Hello again! As promised last week, I’ll be sharing photos documenting my dressing change process today!
To those not on therapy, what does this mean? It’s essentially clean up day. It’s taking the sticker part of my central line off, cleaning it, and re-dressing it (putting the sticker part back on!)
For those on therapy, my process is not the “norm,” but then, what is? Lots of us who have had central lines for many years become allergic to soaps, dressings, adhesives, and all kinds of things over time. Therefore, my dressing change might look completely different from yours! But guess what, we are all different and that’s what makes life fun 🙂
Understand that I say these things because it is terrifying to share these types of processes to the world because people attack things they do not know or think you do wrong. Maybe it looks like I’ve put my sterile gloves on wrong, laid something here wrong, but I promise I have a strong education. If you’d like to have a conversation about something, I absolutely welcome that. But please use kindness. I always say these things to protect myself, but I love sharing so that people can get a look into what this life looks like.
Of course, this is not me saying this is the one and only right way! This is just the way that has worked for me over the past 8 or so years. Never change your process without speaking with your infusion nurse or doctor who gives you instruction!
Anyway, let’s hop to it!
First and foremost, I put on some great music so that I can be entertained during the whole process. Once those sterile gloves go on, it better be a solid music selection on!
Then I wash my hands super duper well and dry them off with a clean towel or paper towel! This is what it looks like right before I start a dressing change (ha! I look so thrilled.)I open up my dressing change kit, put my mask on, then lay all of my supplies out all nice so that they are accessible and remain sterile for the change. ( I do not keep my sterile field sterile, I drop my sterile outside items into my dressing change kit tray. You will see my flush syringes on my sterile field, don’t freak out! I know they are not sterile, promise.)The supplies I use include:
- A dressing change kit with Betadine swabs (I am allergic to Chlorhexidine)
- Two sterile 2×2 gauze pads
- A Cavilon Swabstick
- A Silverlon Disk (comparable to a Biopatch, but does not contain Chlorhexidine)
- A Mepore Film dressing
- An end cap (goes on the end of the central line and must be changed weekly and after blood draws based on the protocol I use)
- 2 saline flushes
- 1 heparin flush
- A Swabcap to finish it all up!
After I’ve got it laid out, I quirt the contents of one saline syringe onto the two gauze pads.
Then prep my new end cap with the other saline flush.
Then I use some tape (that I’m highly allergic to if I leave on!) to tape my line to my chest because I’m freaked out by gravity.
I then pull the week old dressing off, including the little black circle part. That is called a Silverlon patch. Then it looks like this. Just a lil white silicone tube guy hanging out of my chest. The little stringy thing you see is a stitch that I had in at the time to help it adhere to my body.
Then on go the sterile gloves.
Then on to swabbing with the Betadine swabs! There are three, and I go from the inside, out. To keep the clean inside and the dirty out. Then I let it sit on my skin for 2-3 minutes so that it can do it’s scrubbing bubble work! And cross my fingers there’s a really great song on at this time while I cannot touch anything and just have to stand there for those minutes!Next, since I’m allergic to Betadine when it stays on my skin long term, I use those saline soaked gauze pads to carefully wipe it off. In the same inward to outward motion. Once it’s all nice and cleaned up, I put a skin protectant product called Cavilon around the border of where my dressing will sit. Thankfully I am not allergic to this product! After the Cavilon dries, I put on the Silverlon patch! I do not wrap this disk around the line like some folks do. The stress of getting that next dressing off while trying not to pull my line out with that situation is terrifying. And they are effective sitting atop the insertion site.Then I place my dressing. (Yes, I do have my gloves off, but as long as I do not touch the back of the dressing that will be touching my site, the dressing remains sterile, so don’t fret!)
Then I take the boarder off and voila! Then it’s end cap change time! First I scrub around the part that screws onto the end of my line super well.Then I grab the primed new end cap and have it ready to go (this is my least favorite process as there are so many potential error points of touching this of that or the other.)Off with the old cap, and on with the new!Whew! It’s on! Flush with saline, flush with heparin, then twist on a nice little Swabcap, and I’m done till the next week!A new (and not pictured) step of this process is now using a 3M Silicone tape to reinforce the dressing. I had a new line placed in November of 2018 (very near the original site spot) but for some reason, my skin started wanting to repel the dressing at the exit site. So that’s new, but I don’t have photos of it currently! I will share at a later date. It’s a very nice way to tape your dressing to stay on.
And that’s the end of that process! In all honesty, it’s one of my least favorite parts of my week. I really really hate dressing change day. But you know what, it doesn’t take nearly as long as I feel like it takes in my mind. And I remind myself of that each week. It also makes me itchy for a day or so, just due to the new dressing and use of soap and whatnot. But it’s all worth it to keep my lifeline squeaky clean and happy!
Thanks for following along! Would love to hear from you all with any questions!