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Skin around the catheter: irritation or infection?

Dressing adhesive, antiseptic and sweat can irritate the skin around a line. Sometimes, though, redness is a sign of infection. Your team tells the difference; your job is to notice and tell them.

Last updated: ~1 min read
A central line in the neck held in place by a dressing on the skin
Figure 1.Check the skin around the line

01Short answer

Look at the skin around the dressing every day, and under it if it is clear. Itching, a fine rash or redness along the edge of the dressing is often irritation from the adhesive; your team can choose another dressing or a skin barrier. Do not scratch, lift the dressing or apply cream. Spreading redness at the exit site, swelling, warmth, pain, pus, blood, a temperature or chills may mean infection: call at once. Also call if the tubing has pulled out further or your arm is swollen. Wear cotton underwear and loose clothing.

02Simple explanation

Look daily.

No scratching, no cream.

Itching: tell us.

Redness plus fever: call.

03Scientific explanation

MedlinePlus: redness, swelling or discharge at the line site and a fever can be signs of infection and need prompt attention.

NCI: chemotherapy can lower neutrophils, platelets and red cells, which raises the risk of infection, bleeding and fatigue.

04What happens in the body?

Contact dermatitis

A skin reaction to adhesive or antiseptic.

Exit-site infection

Infection where the line leaves the skin.

Neutrophils

The first defence against infection; when they are low, hygiene matters most.

Platelets

Help blood clot; when they are low, protect yourself from injury.

05Daily protection: four steps

Wash, protect, check, report.

Wash — Hands and personal hygiene.1WashHands and personal hygiene.
Protect — Against injury and infection.2ProtectAgainst injury and infection.
Check — Temperature and skin.3CheckTemperature and skin.
Report — Tell your team about changes.4ReportTell your team about changes.
HygieneClean hands.
TemperatureThe 38 °C threshold.
ProtectionYour team's rules.

06Key points at a glance

TopicIn brief
Contact dermatitisA skin reaction to adhesive or antiseptic.
Exit-site infectionInfection where the line leaves the skin.
NeutrophilsThe first defence against infection; when they are low, hygiene matters most.
PlateletsHelp blood clot; when they are low, protect yourself from injury.

07Key terms

Exit site
The point where the line leaves the skin.
Skin barrier
A layer that protects skin from adhesive.
ANC
Absolute neutrophil count.
Thrombocytopenia
A low platelet count.

08Key points

  • Look.
  • Do not touch.
  • Tell us.
  • Wash your hands.
  • 38 °C: call.

09Frequently asked questions

The dressing itches.

Your team can choose another one; tell them.

The tube has slipped out a little.

Do not push it back; secure it and call at once.

What should I watch every day?

Temperature, bleeding, tiredness and the catheter site; tell your team about any change.

10Questions for your doctor

Take these questions to your appointment. The ones you save are collected on the “My questions” page and stay on this device only.

  1. The dressing itches.

  2. The tube has slipped out a little.

  3. What should I watch every day?

My questions

12Sources

  1. MedlinePlus. Central venous catheters - ports
  2. MedlinePlus. Peripherally inserted central catheter - flushing
  3. National Cancer Institute. Infection and Neutropenia during Cancer Treatment
  4. National Cancer Institute. Bleeding and Bruising (Thrombocytopenia) and Cancer Treatment
  5. National Cancer Institute. Anemia and Cancer Treatment
  6. World Health Organization. World Hand Hygiene Day
  7. National Cancer Institute. Skin and Nail Changes during Cancer Treatment
  8. National Cancer Institute. Coping – Life After Cancer Treatment
  9. National Cancer Institute. Coping – Cancer Support Groups
  10. National Cancer Institute. Sexual Health Issues in Women and Cancer Treatment
Medical disclaimerThis information is for educational purposes only and does not replace medical advice.
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