Answer 18

Patient complains of pain and burning during central line dressing changes with chlorhexadine. Central line exit site has the following appearance (see below).  What is the proposed treatment plan?

cvs4

A. Use betadine cleanse for central line dressing changes for chemical burn.
B. Prescribe IV antibiotics for central line exit-site cellulitis.
C. Surgery consult for central line removal to treat central line exit-site infection.
D. Increase zinc supplementation for deficiency.
E. Increase IV lipids for essential fatty acid deficiency.

 

The correct answer is a. Use betadine cleanse for central line dressing changes for chemical burn.  This is a chemical burn in the shape of a central line dressing, which commonly occurs when chlorhexidine is left wet underneath an occlusive dressing. Treatment entails switching to a betadine dressing temporarily until the dermatitis resolves. These issue is often misdiagnosed as an exit-site cellulitis. IV antibiotics and procedures are not necessary. Zinc deficiency is associated with patches of red and inflamed skin around the mouth and anus. Fatty acid deficiency is associated with generalized scaly rash.