Picc Line Problems

I haven't seen any posts on this, it seems to be a rare problem. I thought my husband's experience might help someone else. He had a Picc line inserted at MDA and received first chemo. I was taught to flush and dress the insertion point. After he was discharged, we drove 9 hours home. When he removed his shirt, the dressing was wet. It was a gauze type dressing with a wide band of adhesive at the edges. I changed the dressing and the next day it was stained and damp again. When I changed it again, I could see that the skin under the adhesive area was red. We went to our local oncology office and they switched him over to a 4 x 4" Tegaderm that includes a non-adhesive pad over the insertion point. Next day we could see fluid under the clear plastic. Returned to oncology office where they switched to 2 small Tegaderm patches with sterile gauze to protect the insertion and allow inflammed skin to dry out, and started him on Bactrim to bring down the swelling and redness. Fluid oozing continued, so the Picc line was replaced, old line was tested without being able to find a leak. Overnight, more fluid accumulated inside the Tegaderm patch, and now the skin outside the dressing is healing, but the skin under the patch is getting red. Rather than call the professionals, I searched on line and found a site for cystic fibrosis and another for nurses that discussed weeping skin around a picc line and adhesive allergy. Found 2 similar suggestions which I have followed and now 5 days later his skin is clear.
1) Place a bio-patch over the insertion point, hold it in place by lightly taping to the butterfly. Cover with 4 x 4" sterile gauze, tape corners and change daily.
2) Place 2 x 2" sterile gauze over the insertions point. Hold in place by lightly taping to the butterfly. Cover with 4 x 4" sterile gauze, tape corners and change daily.
I have alternated between the biopatch and the all gauze dressing. I found that when paper tape or 3M micropore tape got wet, it was very difficult to remove and irritated his skin. I use the same Nexcare flesh colored waterproof tape that I use to make Press and Seal waterproof for showering. It sticks beautifully and releases instantly with no pain or irritation. We now know that he has interstitial fluid seeping from the insertion point. As the inflammation dimenishes and the skin around the cather closes up, we see less and less fluid on the gauze. When you are dealing with high grade muscle invasive BC with probable lymph involvement and just starting chemo, this is relatively minor, but it felt like a crisis that was going to push us over the top. Hope this may help someone else.

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I think this is an excellent post. Thank you for sharing your experience.

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matteo has picc as well, grrrr they are very high maintenance we have to use heprin daily with a drg change weekly!
a port almost seems less risky
tks for sharing xoxoxo

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I am a PICC certified nurse and this is a rarety. Since the catheter has been replaced and there is still a problem I would have to say it is your husbands skin weeping. I would recommend a bio patch with an iv 3000 type dressing. It always for some transfer of fluid. If that does not work than gauze with an every 48 hour dressing change. Hope that helps.

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Under the stress of cancer, nothing is minor, particularly when the caretaker is thrust into providing medical care with no background in medicine. It IS stressful particularly when added to caring for a patient who is receiving chemo.

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just a note that if you have any skin irritation with the tegaderm iV 3000 is a nasty drsg and sticks like a sun of a gun and i would not pull that off every couple days as it's ment to stay in place for up to 7 days i use that drsg for matteo because of the fact that it sticks so well and helps protect his over active 3yr old lifestyle. i'm a wound care nurse and the more you rip off the more chance for infection your going to have to figure out how to keep the skin from weeping and keep the drsg on as long as possible so i agree maybe a 2x2 over the insertion site layered and when u see the wetness through it change it! best practise i would say get some silver drg maybe pharmacy has or some sea sorb(soeaked with salt) will help absorb the exudate and draw it away from the good skin and will eat any bacteria ask the hospital for some of these a wound care or ET nurse will have access this will for sure with out a dout help keep the drsg dry for a week !

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Thanks all. I am changing the dressing every 24 hours, alternating the cover over the picc line between the biopatch and 2 x 2 sterile --no tegaderm, just a 4 x 4 sterile lightly taped with the Nexcare waterproof on the corners. He is still getting interstitial drainage around the insertion point, but it is dimenishing. But the redness has totally disappeared and the skin is almost healed. I'm glad to hear this is rare, maybe the professionals we were relying on just hadn't seen it before. Watching it get worse and worse sort of shook my confidence in the team.
Does this mean we are going to have real problems with the stoma adhesives after surgery?

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