Examining the Role of Securement and Dressing Products to Prevent Central Venous Access Device Failure: A Narrative Review

• Central venous access devices continue to fail prior to completion to therapy at unacceptably high rates.
• Securement and dressing products prevent central venous access device failure via providing a barrier to microbial colonization and reducing motion; but this may be impacted during dressing disruption
• A ‘one size fits all’ approach for central venous access device dressing and securement is inappropriate, due to the heterogeneity of the patient populations, the insertion placement and devices used.
• All clinicians that rely on these devices to provide treatment should be aware of the importance of providing effective central venous access device securement and dressing to prevent failure and complication.

ObjectiveTo describe the underpinning principles involved in central venous access device (CVAD) securement and dressing products to prevent CVAD failure and complications through a synthesis of research studies.BackgroundFunctional, dependable CVADs are a necessary part of patient care. Dressing and securement products are used to prevent CVAD failure and complications, but there is a large variety of products available for clinicians to access, with variable effectiveness.MethodsA narrative review of studies describing the mechanisms for CVAD securement and dressing products to prevent failure and complication was undertaken. After a systematic search, 20 clinical and laboratory studies were included in the review.DiscussionThe major mechanisms by which CVAD dressing and securement products prevent failure are providing a barrier to microbial contamination and motion reduction. CVAD securement and dressing products provide these functions using coating, adhesion, antimicrobial properties, absorbency, and moisture vapor transmission without causing irritation to skin and maintaining visibility of the insertion site. The complexity of patients requiring CVAD securement and dressing means that universal recommendations across CVAD populations and broad generalization of studies from single populations (eg, intensive care) or devices (eg, peripherally inserted central catheters) are ill advised.ConclusionsCVAD securement and dressing products provide important, multifaceted functions to prevent CVAD failure and complication.