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November 11, 1992

Transparent Polyurethane Film as a Catheter Dressing-Reply

Author Affiliations

University of North Carolina Chapel Hill
Duke University Durham, NC

JAMA. 1992;268(18):2515. doi:10.1001/jama.1992.03490180046017

In Reply.  —When comparing the infection risks of transparent vs gauze dressings used on central venous catheters, the RRs were 1.78 for catheter-tip infection, 1.63 for bacteremia, and 1.69 for catheter sepsis. These RRs represent the best assessment of the overall risk associated with the use of transparent dressings. (For catheter-tip infection, P<.001; for catheter sepsis, P=.06.) In our discussion we used the word "trend" in discussing this level of significance. The choice of .05 as the level of "statistical significance" is arbitrary, and given the RRs demonstrated in the meta-analysis, further studies are warranted before accepting transparent dressings as safe.Dr Berry notes that a recent review by Maki1 states that quantitative cultures of catheter tips have a "15 to 40 percent association with concomitant bacteremias." We disagree with Berry's conclusions regarding the significance of a positive catheter-tip culture. Dr Maki notes that "most catheter-related septicemias derive