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Jose N. Recipient

Skin irritation from adhesive

I've had my device for 3 years and the past couple of months, the skin under the bandage and the foley anchor has started to itch, but I don't know from what. I don't know if it's the Tegraderm, the cloraprep which my doctor said to switch to alcohol to clean the area, or the skin prep solution. I've tried using iodine to try to switch from the cloroprep with no results. Just started trying alcohol which worked for a couple hours then started itching. During bandage change I've tried cleaning the area well with adhesive remover, applying itch relief cream on the skin and leaving it covered with a 4x4 sponge for an hour with no results. It's driving me crazy and Idk what else to do.
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P D.

My husband has had his VAD for just three months. Our kits come with cloraprep , we have been instructed to let it dry two minutes and follow with sterile water wipes , also in the kit, to remove the cloraprep, at least dilutes it some, to prevent irritation . Maybe, the sterile water wipes is something you could try.
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Samantha B.

My father has the same issue - he will use hydrocortisone cream, sometimes when it is really bad he will leave the dressing off for a few hours and let the hydrocortisone really soak in. In his kits he has hibiclens cleaning solution which can irritate the skin so we acually use some of the sterile water to dilute it to help with the irritation. All of these surgical scrubs are very irritating to the skin. Also unless he has been outside working and gotten very sweaty we change his dressing 3 times a week (all of this ok'd by his doctor and LVAD coordinator). Also when my mom changes his dressing they use an adhesive remover for all the tape residue, something like gojo but not quite. They are orange smelling pads. they are currently using All of this combined has really helped with the irritation from the cleaners and the tape.
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Phil S.

My mom switched from the hibiclens & saline protocol to the Chloraprep not too long ago and she started having terrible itching as well. I found that by wiping the area with saline and sterile gauze a few times a week helps with the itchiness as it removes the layer of dried chloraprep that builds up with each application.
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Phil S.

http://www.3m.com/3M/en_US/company-us/all-3m-products/~/3M-Medipore-Soft-Cloth-Surgical-Tape?N=5002385+3293321963&rt=rud We switched from the standard "silk tape" to "Medipore Tape" and that has helped with the itchiness as well. It's softer and also scored so it tears easily from the roll. We just have the 3 inch wide rolls, but they come in different widths. In three months, they are going to switch her from a 4x4 dressing to a 2x2 and that should help too because the dressing won't be so big to tape over. It also comes off easier. On non-dressing change days, I sometimes have to reinforce the site with some standard silk tape, but at least that part isn't touching the skin.
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Dorothy T.

Hello! My patient uses the Driveline VAD Dressing care kit for Heartware by Centurion. There was an intense itching around the driveline entry site about three months after we started. The VAD Coordinator suggested leaving off the Biopatch around the entry site of driveline. That worked like a charm. We were told that some people are allergic to Hibiclens. Also alcohol swabs are good for cleaning the skin and removing residue. Our kit contains also a skin protector patch similar to the alcohol swab. We wipe the skin protector around dressing site and let dry before applying the tape. We also apply the skin protector on the skin before placing the foley anchor.
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In reply to by Dorothy T.

William M.

Sounds like you have a pretty sharp VAD coordinator. Allowing the CHG skin scrub (whether ChloraPrep or Hibiclens) to dry COMPLETELY is extremely important to help prevent skin irritation! While the BioPatch antimicrobial disk is very important to help fight against driveline infection, some patients do experience skin irritation/burn at the site. So she was smart to leave it off, even if it's only for a given period of time. Just curious, which dressing is in your Centurion kit? Thanks,
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Dorothy T.

Hello! My patient uses the Driveline VAD Dressing care kit for Heartware by Centurion. There was an intense itching around the driveline entry site about three months after we started. The VAD Coordinator suggested leaving off the Biopatch around the entry site of driveline. That worked like a charm. We were told that some people are allergic to Hibiclens. Also alcohol swabs are good for cleaning the skin and removing residue. Our kit contains also a skin protector patch similar to the alcohol swab. We wipe the skin protector around dressing site and let dry before applying the tape. We also apply the skin protector on the skin before placing the foley anchor.
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Phil S.

My mom had a similar problem. She used to have 4x4's and the silk tape used for that dressing was really tearing up her skin. Lots of red blotches and terrible itching. New she uses the 2x2 split gauze, 2x2 cover sponge, tape with medipore tape and the split tape holding the edge of the driveline. The medipore tape is a lot easier on her skin. She also uses the chloraprep applicator. Letting it dry completely is essential to eliminate the itching. Also, every couple weeks we do a saline rub with sterile gauze to remove the dead skin and build-up from the chloraprep. That really help her itching. For the areas of skin that are really irritated from the tape, what we do is the 2x2 dressing as above but without securing with medipore tape yet. Then use 100% aloe vera gel around the edges. Then use a 4x4 cover sponge over everything and then tape with the medipore tape. Her redness cleared up in just two days and no more itch. WalMart sells the aloe vera gel we use. You only need a small bit to spread around, so this bottle will last a long time. https://www.walmart.com/ip/Fruit-Of-The-Earth-Aloe-Vera-Gel-12-oz/10314797
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In reply to by Phil S.

William M.

For what it's worth, Hygea (from PDI) makes 4x6 sterile saline wipes in single packets. They're super saturated and very convenient. These are great for placing inside your dressing change kits, or keeping in purse just in case.
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Anonymous

TELL your doctor you want a script for the PRESCRIPTION STRENGTH Hydrocortisone cream...it is 2.5%!....the alternative??......the over the counter worthless Hydrocortisone crap is only .05% or 1%. COMPLETELY INEFFECTIVE....should not even be sold to those who need help for relief! Believe me, will make a huge difference if you are having a lot of itching from the tape they use to secure a bandage/dressing from a surgery. I have had a constant bandage on my stomach area ( colostomy surgery ) due to severe Diverticultis. Even though bandage gets changed often the constant use of the tape on me has made me itch and burn so much so it wakes me up in middle of night. Some of us have skin that is very sensitive to the constant tape that is put on us while a surgical wound heals. I have been constantly bandaged now for a month! and my skin in certain areas is now so deep red and a rash, too. Some of this is close to the wound itself and I am concerned for fear of wound infection starting, yet the nurse who comes to my home often just cleans area, applies the 2.5% prescription strength Hydrocortisone ( my idea in the 1st place not hers!! ) , lets it soak in skin and then dresses wound and then here comes all that tape again to secure the fresh bandage ( a big one, too ). This cream is effective for the severe itching and burning, but remember DO NOT BUY the worthless, ineffective over the counter Hydrocortisone junk...and do not let anyone tell you different. Hope this post helps some of you as it has me....believe me I know what you are going through and I wish you all a safe and quick healing process. Good luck.
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Jose N.

Wow, I forgot I had an account here! XD To update, my team and I have managed to cut down on the itching. The company I get supplies from started including Cardinal Health adhesive remover wipes which help the obvious adhesive left behind. After that it's Cloraprep, then saline wipe to get the excess that's dried on, repeat that, then extra gauze under the drive line that runs under the rest of the bandage. Now, the only part of the bandage that actually touches the skin is the border. I feel so much better.
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Sheri B.

Itching and burning are common problems among VAD patients. The most common culprits are Chg cleansers or Biopatch (also Chg-based), and adhesives. Skin breakdown and stripping is often a result of constant dressing changes. There are optional very effective products available for sensitive skin that can be billed to your insurance along with your other supplies. Some are now in a kit format. http://www.vadsupplies.com/product-category/products-for-sensitive-skin/page/2/ Comments: Chloraprep - letting the chloraprep cleanser dry thoroughly before covering the area with a dressing will lessen the chances of skin irritation. The Chloraprep One-Step seems to be the best tolerated Chg cleanser. Avoid the use of Chloraprep cleansers with fragrance or color like Hibiclens. The problem with diluting Hibiclens is that one must be certain the product maintains the necessary antimicrobial effect by not diluting it too much. If you are sensitive to Chg and/or Biopatch, consider using the Silverlon disc around the driveline. http://www.vadsupplies.com/product/silverlon-lifesaver-disc/ Alcohol is drying and can cause itching. It also has no antimicrobial benefit. If you change dressings every couple of days, consider Anasept. It is highly effective against all pathogens that can cause infection. http://www.vadsupplies.com/product/anasept-antimicrobial-skin-and-wound-cleanser/