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Robert K. Recipient

Exit site dressing

I have a problem with the adhesive used on the dressing. My problem is I get skin tears when removing the dressing! They bleed and since I take warfarin to keep my INR correct they are hard to stop. We tried different dressings and cleaning agents but I stil have this problem. Any ideas would be appreciated,Robert.
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Joanne C.

You might try a long-lasting dressing, like the anchor dressing, cut and applied on either side of your exit site. Then you can tape to the dressing, not your skin, and only change the anchor-type dressing as needed. I would check with my coordinator for an o.k. first, but it might keep you from having to rip off skin daily.
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Donna B.

My husband had the same problem with Tegaderm. I switched to "IV3000 Standard" transparent dressing by smith & nephew after reading research on it. It is frequently used to cover catheters. It is a sterile clear cover that maintains a dry site so you can shower with it . After changing the sponges, I use a Protective Barrier Wipe around the exposed skin that will be covered and then put on the IV3000. I use an alcohol wipe to ease removal of the transparent cover. No more tearing or irritation of his skin.
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Philip C.

Hi Robkeys1! I've just joined MyLVAD today and I saw your entry. I live in Cape Town South Africa and I've been fitted with the Heartware LVAD since December 2014. Obviously the exit site dressing is really important., especially regular cleaning and changing of the dressing. I change my dressing twice a week but once I left the dressing on too long and picked up an infection. When I change my dressing I first clean the site with an alcohol based cleaning fluid and then use gauze around the exit wound, wrapping the gauze around and then ending with a further layer of gauze on top. I try to make sure that the gauze is fairly small but at the same time gives plenty of coverage and protection. I then use a see through adhesive plaster called Tegaderm which is available worldwide (see I've found Tegaderm works really well as long as I keep the gauze wadding sufficiently small that the Tegaderm has plenty of margin to stick to my body. Its a bit of a tricky balance doing this but I've got used to it with plenty of practice and mistakes! I have had bleeding under the Tegaderm but not in a major way. I've found that two things help. Firstly, I keep the area of my body where the Tegaderm sticks free of body hair by shaving regularly so that the Tegaderm sticks more easily. Secondly, I change my dressing lying flat on the bed and resting my head on pillows so that I can see. By doing this my body is not bent over, which it would be if I changed the dressing while seated. I've found from experience that if the Tegaderm is fitted while seated it then has to stretch quite considerably once I'm standing up, and so tends to pull on the skin and create bleeding. I hope this helps!
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Warren B.

My sister use alcohol Cotton balls . Gently lift tape and rub the Cotton balls under it. And gently lift the tape We also stopped using skin prep.
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Barbara G.

Hi, Rob! My husband also had some issues with the dressing for a while. We were using tegaderm bandages in the beginning, which worked great, but were too expensive to continue using. He was blessed to be put on the VADwatch program, which provides all of our dressing supplies. Unfortunately, he developed a rash from the bandages they sent us. Not sure what they are called- they're made by Centurion & they're very nice & big, probably 5x5, but he has sensitive skin and when you're doing this every day it's tough on your skin. After the tegaderms had run out I started buying the Publix brand sheer pad bandages. They are smaller- 3x4 inches- but they are sterile and we've never had a problem with them. So we went back to them. They are less than $3 for a box of 10. He does have some redness occasionally, but I use the skin prep pads made by Smith & Nephew and it clears up within a day or two. I haven't had to use one in months, though. Being on coumadin changes your life, that's for sure! We ended up in the ER once because he had a small scrape inside his mouth that bled all night. Turned out his INR was over 7!! Anyway, hope you find a dressing that works for you.
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Beth D.

My brothers LVAD coordinators taught me to use skin prep protective barrier wipes. They provide a protective barrier between tape and skin. 3M Cavilon No Sting Barrier Film is what I use on my brother's site as the barrier wipe originally used in hospital stings sometimes and the 3M does not. Hope this helps.
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David M.

Rob, ask your LVAD medical supplier for Unisolve. It's a wipe that breaks done the glue of bandage. Works wonders for me.
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Sue S.

My husband had the same problem. Our hospital recommended we use Cavilon on the skin where the dressing goes. We get it from Alere, who sends us our bandage kits and other supplies. They are individual packets, and inside is what looks like a lolipop, and about the same size. It's a plastic stick with a flat foam head that has the liquid in it. You just wipe it on the skin - the last step before applying the dressing. Works like a charm!
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Gregory D.

Use this: MSC1528H $15.39 Each 2 $30.78 Medline Sureprep No-Sting Skin Protectant Spray options: 28ml Bottle This is from HFPY on-line, not cheap but works great.