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Stephen G. Recipient

Foley Anchor and rash

I am the proud owner of a Heartmate 3 LVAD. I have had it for 15 months now and have has an interesting ride, but that is for a later post.

My issues have been with driveline management and skin rashes. My skin is very sensitive to tape and adhesives and it has been a challenge to find the most comfortable dressing and foley anchor. I was using the Centurion FCS200XT that the hospital recommended and was having issues with my skin getting irritated. I tried several other anchors that did not bother my skin as much, but the cable management was not as good.  After a lot of research and trial and error I came across a new version of the Centurion anchor. It appears that they have come out with a model Centurion - FCS300XT - Centurion Foley Anchor Urinary Catheter Securement Device, PE Foam. This version looks the same and secures the cable the same but is made of a different material and has a different adhesive.  I have never been so happy since I am using these.  No more rash and the cable stays secure.

They appear to be available from all the normal outlets, just make sure you specify the FCS300XT.  Good shopping.

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KEVIN O.

It seems as though the foley anchors have gotten vey thin and crappy. I used to be able to keep my Foley anchor on for at least a month (the thick one) now they fold over with your skin. Anyone have same trouble ? Also some moleskin wrapped around the driveline connection (Heartmate 3), helps blisters where it rubs on your skin.

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KEVIN O.

It seems as though the foley anchors have gotten vey thin and crappy. I used to be able to keep my Foley anchor on for at least a month (the thick one) now they fold over with your skin. Anyone have same trouble ? Also some moleskin wrapped around the driveline connection (Heartmate 3), helps blisters where it rubs on your skin.

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Peter S.

I had similar issues until some wonderful nurse turned me on to Cavilon wipes. They are used as a skin prep before you apply the dressing. They have helped enormously. 

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Mariza M.

Hi, I’ve been using the folley anchor FCS200XT for almost 3 years and very few skin demage was observed. I change it every 10-15 days depending on its aspect. Icurrently use Cavilon to protect the skin. For dressing, Primapore works quite well, with no rash or skin demage.  The problem with this dressing is that it is not available in Brazil, which make it very expensive due to import taxes. 

Mariza

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In reply to by Mariza M.

Susan S.

That a long time before changing bandages. I do my husbands every other day.  I guess if they (the Lvad Team) were to tell me it was okay I might try, but even after 3 days it seems necessary .

Susan

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In reply to by Susan S.

Gene C.

Susan, what factors make it seem necessary to change dressings every three days? I'm able to change mine every 7 - 10 days. Do you use a kit of dressings with a window one?

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In reply to by Gene C.

Larry B.

ive been on weekly changes since my six month mark which was over 18 months ago. That’s what my team says and that’s what I do. Makes since if you think about it. The more your site is exposed to the elements, the more chances of something getting in there that shouldn’t. But then again, my team lets me take daily showers when some others don’t allow showering at all. I was cleared to shower on my date of discharge which was only 10 days post op.

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In reply to by Gene C.

Terry R.

I have been an LVAD patient since 2012. November 2016 I felt great and in for my semi annual check up. They ended up admitting me because an infection. I was changing my dressing every three days and cleaning the site every change. The VAD team operated twice that month. Removing and replacing the pump and tubing. This year the infection moved to my blood stream and I had to be hospitalized to fight that infection. That was this last month, the whole month. I recommend that site cleaning and changing daily. We treat the site daily with a great deal of attention to keeping it sanitary.  I felt great, but it sneaks up on you. 

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In reply to by Terry R.

june B.

I have had my lvad since November 2017. I have had two infections which were treated with antibiotics. At my appointment in January, 2019, I learned from the infectious disease doctor that I should not run lots of shower water on my driveline site because the water is not sterile. I was amazed because I thought that running the water on it was good and would clean it nicely. I was totally wrong. She said getting a little water on it was ok but not drenching it with shower water. Who knew? I started wearing Tegaderm transparent film patches over my site when in the shower. They have helped tremendously. I got 50 Tegaderm patches for $20 on Amazon Prime. Try those. It might help. Best wishes.

June B.

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Chiplon W.

I've had my Heartmate II for almost three years now. I get all my supplies directly from the LVAD/Heart Transplant clinic at Carolinas Medical Center. And, to be honest, I'm not sure what they give me. I have had a couple of instances of getting irritated. But, my wife who is my caregiver (And, no way in the world could l do without her!!), just cleans the site really well when she removes one, and changes the position of the new one to avoids the previous ones position. I really think moving it slightly is the key to avoid irritation. So, PLEASE be grateful for your chance at a longer life. And, live it to the fullest.

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In reply to by Chiplon W.

Susan S.

I do the same, changing the position so the same area can heal.  It does help.  My husband has had his HeartMate 2 for 2 years.  We are very grateful for his progress.  It been a learning experience , and we accept that.  

Susan

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Cindy R.

Hello, I have sensitive skin as well, and have had great trouble with tape and foley anchors. After many years, here are a few things I have learned and would like to share. I can only use paper tape and that will not change. I could not wear a foley anchors for years because of the adhesive. My husband started layering paper tape, and after 3 layers, the foley anchor can be attached and will not irritate me. Whenever anyone gets a rash, I recommend Clobetasol Propionate ointment, USP, 0.05%. This is a common RX and works well with the skin, but cannot be applied on or very close to the driveline. My dressing changing kits come with a new foley anchor, so it is changed every other day. Whenever I apply ointment, I wear a tank top with a binder over it to keep the dressing down and closed. The tape will stick using this method after the binder is on overnight. Wishing you the best with your LVAD. I am enjoying every minute I have because of mine.
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Mariza M.

Is someone having problems with Coagucheck INR measures? I’ve been using it for about two years and although it had diferent values from the lab performed assay, the variations eere less than 0.5. The last kit, code 330, gave very high values, more than 1.0 compared to the lab tests. Roche sent me a new kit, but it is older than mine and it is also listed in the kits with problems for INR above 4.5, that we finally discover that they also have low accuracy for results below such value. 

Mariza

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In reply to by Mariza M.

Mitchell W.

Mariza, if you are using a Roche CoaguChek XS unit, they had a large batch of mis-calibrated strips that came out. You should have received a letter from them directly or been informed by your doctors office about these strips. I am not 100% sure how high the lot codes were that got "recalled" be we were informed to discard the bad strips and do blood draws until replacement strips got sent out. You might want to check with your doctors office or your strip supplier about your status with the replacement strips. The lot code for the ones I received as my replacements was a 357 code.

Mitch

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In reply to by Mitchell W.

Larry B.

i received notice of the bad lots and had to destroy the stockpile I had built up. My supplier has now went to only sending two month supplies instead of the monthly ones we had been receiving. Also cannot remember the bad lots but there were many. I am also on lot 357 now.

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In reply to by Mitchell W.

Mariza M.

Hi Mitch

Thank your for your clarification concerning the problems with the Coagucheck batches. I have been in contact with them since November and, so far, they haven’t sent a new kit working properly. As I have a laboratory background I created a data set to register the  INR results obtained by Coagucheck since the beginning and included an additional column to add the periodic laboratory data for comparative purposes. With the lots bought until August 2018 the median variation between Coagucheck and laboratory assay used to be less than 0.5. With the lots bought after that this difference became 0.8 to 1.0 higher than lab results. It’s when I realized that there was a problem and contacted them before I received their letter about the problems. Unfortunately here in Brazil things take longer to happen as they have to import the new lots and, although they promised me a new kit fir the end of January I haven’t received anything yet and have to keep doing only lab assays.

Mariza

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In reply to by Mitchell W.

Mariza M.

Hi Mitch

Thank your for your clarification concerning the problems with the Coagucheck batches. I have been in contact with them since November and, so far, they haven’t sent a new kit working properly. As I have a laboratory background I created a data set to register the  INR results obtained by Coagucheck since the beginning and included an additional column to add the periodic laboratory data for comparative purposes. With the lots bought until August 2018 the median variation between Coagucheck and laboratory assay used to be less than 0.5. With the lots bought after that this difference became 0.8 to 1.0 higher than lab results. It’s when I realized that there was a problem and contacted them before I received their letter about the problems. Unfortunately here in Brazil things take longer to happen as they have to import the new lots and, although they promised me a new kit fir the end of January I haven’t received anything yet and have to keep doing only lab assays.

Mariza

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june B.

Thanks for the info. I have been having the same issues with my anchors. They constantly itch and cause rashes. I will definitely be trying to find the anchors you have recommended.

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june B.

Hi Stephen G.,

Thank you for the info about the Centurion Foley Anchor FCS300XT. I just spoke to my LVAD coordinator and will be getting some of those anchors because the other ones give me rashes and are very itchy. Thanks again.

June B.

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june B.

I was having a problem with the skin irritation and itching. Because of your comments, I had my supply company send me the anchor you suggested and it seems to be doing much better. Thank you for sharing.

Blessings!

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Sheri B.

Wound Care Resources, a national VAD supplier for dressings, specializes in providing products for "sensitive" skin.  We find that over time, many VAD patients develop sensitivities to adhesives and Chg products (like cleansers and Biopatch). See some of the specialty products we provide and bill for VAD patients every day.  These are often sent along with VAD kits and utilized instead of the offending product in a kit.

Gentle Window https://www.vadsupplies.com/product/gentle-window/

UniGrip Anchor https://www.vadsupplies.com/product/unigrip/

Silverlon disc    https://www.vadsupplies.com/product/silverlon-lifesaver-disc/

Kind Removal Tape https://www.vadsupplies.com/product/kind-removal-tape/

Anasept Antimicrobial Wound Cleanser                                    https://www.vadsupplies.com/product/anasept-antimicrobial-skin-and-wound-cleanser/

Sensitive driveline management kit                                  https://www.vadsupplies.com/product/sensitive-driveline-management-tray-77952/

Sensitive driveline management kit                                        https://www.vadsupplies.com/product/sensitive-driveline-management-tray-77774/

WCR also carries Tegaderm two other brands of shower covers.  Our largest is 9" x 12".

Please call me if you want to access or discuss any of these products.  I will be glad to contact your VAD team if you would like to access any of these:

Sheri Bishop (901) 292-8113