Thesis--Auburn University, 2009. / Abstract. Vita. Includes bibliographical references (p. 36-42).

Thesis (M.A.)--University of North Carolina at Chapel Hill, 2005. / Includes bibliographical references (leaves 109-114). Also available online (PDF file) by a subscription to the set or by purchasing the individual file.

Thesis (M.A.)--University of North Carolina at Chapel Hill, 2005. / Includes bibliographical references (leaves 109-114).

M.Tech. (Chiropractic) / Myofascial Pain Syndrome, is a common source of frustration for both healthcare practitioners and patients. It is the second most common reason for patients visiting their health care practitioner and constitutes up to 85% of the reasons for visits to pain clinics (Han and Harrison, 1997). As muscle pain is the most common work-related injury (Hubbard, 1998), it costs billions of dollars in lost revenue every year due to lost productivity (Fricton, 1990). Hong (1994), states that dry needling has been extensively studied and has been shown to decrease or even abolish myofascial pain. However post dry needling soreness is a common side effect of dry needling. Stuart (2010), states that applying kinesio tape® to a musculoskeletal injury during rehabilitation could result in a quicker recovery by allowing the body to biomechanically heal itself. Garcia-Mura et al (2009), results suggest that kinesio tape® is a method highly appropriate in the treatment of myofascial trigger points by normalising muscular function, increasing lymphatic and vascular flow, diminishing pain and aid in the correction of possible articular malalignment. The aim of this study was to determine the effects that kinesio tape® has on the trapezius trigger point one post needling, to determine whether there is an increase in the therapeutic effect of dry needling and an increased recovery time of the myofascial trigger points, with regards to changes in pressure pain threshold, pain and cervical range of motion. Participants for this study were recruited either by an advertisement which was placed on the information board of the Chiropractic Day Clinic at the University of Johannesburg as well as advertisements placed in and around the University of Johannesburg at the Doornfontein Campus. Also, many participants were made aware of this study via word of mouth from candidates already involved in the study. Thirty participants were randomly assigned into one of two groups, each consisting of 15 participants. Group A received dry needling of the trapezius trigger point one followed by the application of kinesio tape® whereas group B received dry needing of trapezius trigger point one only. Participants were treated 5 times with objective and subjective measurements taken at the 1st, 3rd and 5th visits. Objective measurements consisted of readings taken with an algometer and cervical range of motion (CROM) device. The subjective measurements consisted of the Numerical Pain Rating Scale (NPRS) and the Vernon Mior Neck Disability Index. The results of the study showed clinically and statistical significant improvements for both groups in regards to alleviating pain subjectively (Numerical Pain Rating Scale and Vernon-Mior Neck Pain and Disability Index), increasing pressure pain threshold objectively (Algometer) and increasing range of motion objectively (Cervical Range of Motion device). However group A (dry needing and kinesio tape®) showed a greater improvement in both subjective and objective measurements. Based on the results of the study, it could be concluded that both dry needling on its own as well as applying kinesio tape® post dry needling can be effective in the treatment of myofascial trigger points in the upper trapezius muscle, however applying kinesio tape® post dry needling seemed to be more effective.

INTRODUCTION: For persons with diabetes, surgery is fraught with complications; of primary concern is postoperative infection. A postoperative infection rate of up to 13% has been noted in patients with diabetes undergoing elective surgical procedures compared with less than 3% in nondiabetic populations. OBJECTIVE: The objective of this study was to provide preliminary evaluation of the efficacy of a novel bioresorbable microfilm matrix (20 µm thick) containing very low amounts of silver (0.16 mg/in²) in preventing surgical site infections when placed at the level of subcutaneous tissue and dermis prior to primary closure in the patient with diabetes undergoing elective surgery. MATERIALS AND METHODS: Twenty-two patients with diabetes undergoing nonemergent or elective foot or ankle surgery and who met at least 1 of the following 6 criteria were included in the study: neuropathy, infection, open wound, history of recurrent infection, nonhealing wound, or peripheral vascular disease. Patients underwent amputation, removal of exostosis, midfoot bone removal, Achilles tendon repair, bunionectomy, or an elevating osteotomy with primary closure of the wound. After hemostasis was obtained and subcutaneous closure achieved, if applicable, the bioresorbable microfilm matrix was applied just deep to the incision at the level of subcutaneous tissue and dermis, and the incision primarily closed. A nonadherent cover dressing was applied over the suture line, and routine follow-up was scheduled for 3 to 5 days later. RESULTS: No patient exhibited signs of infection at initial follow-up, and all adherent patients achieved complete healing during the 3-month follow-up period. Eighteen patients healed at a rate typical for the respective procedure. In 2 patients, time to healing was delayed secondary to weight-bearing dehiscence. Two patients were not included in the results secondary to multiple infractions of nonadherence with the postoperative protocol. CONCLUSIONS: The application of microfilm matrix in surgical incisions at the level of subcutaneous tissue and dermis prior to primary closure is safe for and has the potential to prevent postoperative surgical site infections in at-risk patients with diabetes..

Le kinesiotape est une ressource complémentaire largement utilisée dans les cliniques pour le traitement de nombreuses pathologies musculosquelettiques, qui a été suggéré comme un traitement efficace pour diminuer la douleur et les limitations fonctionnelles chez les individus avec une tendinopathie de la coiffe des rotateurs (TCR) par l’augmentation du retour proprioceptif, qui contribuerait à l’amélioration du contrôle neuromusculaire de l’épaule. L’objectif de cette thèse était de déterminer si le kinesiotape engendre des gains supplémentaires à la réadaptation des individus avec TCR à moyen et long terme. L’efficacité du kinesiotape à moyen et long terme a été étudiée lorsqu’utilisé en association avec un programme de réadaptation de six semaines, basé sur l’entraînement sensorimoteur pour restaurer le contrôle neuromusculaire de l’épaule. Pour atteindre nos objectifs, 52 individus diagnostiqués avec une TCR unilatérale ont participé à un traitement composé de 10 séances de physiothérapie et d’exercices à la maison. Les participants ont été assignés, aléatoirement, à l’un des deux groupes (KT [expérimental] ou No-KT [contrôle]), dans lesquels le groupe KT a reçu une application thérapeutique de kinesiotape, spécifique pour la TCR, en plus du programme de réadaptation, alors que le groupe No-KT a reçu seulement le programme de réadaptation. Le programme de réadaptation était le même pour les deux groupes, incluant un entraînement sensorimoteur, la rééducation du patient, des exercices résistés pour le renforcement musculaire, de la thérapie manuelle, et des étirements. Un plan de traitement individuel a été personnalisé et mis en place pour chaque participant. Les techniques utilisées variaient en fonction des besoins spécifiques de chacun. Le niveau de symptômes et les limitations fonctionnelles ont été évalués avec le questionnaire Disabilities of the Arm, Shoulder, and Hand (DASH), le Brief Pain Inventory (BPI), et le Western Ontario Rotator Cuff (WORC) à cinq moments (évaluation initiale, 3, 6 et 12 semaines, et 6 mois), alors que les amplitudes de mouvement (ADM) de l’épaule, sans douleur et complète, et la distance acromio-humérale (DAH) au repos et à 60° d’abduction active de l’épaule, ont été évaluées avant (évaluation initiale) et après le traitement (semaine 6). De plus, l’effet immédiat du kinesiotape sur l’augmentation de la DAH et sur l’amélioration de la capacité de repositionnement articulaire actif des individus avec TCR a également été évaluées avant la première séance de physiothérapie chez les participants du groupe KT (devis transversal). Globalement, 78.8% des participants ont rapporté un changement positif significatif de leur condition à la fin du traitement. Les résultats de l’essai randomisé contrôlé (ECR) montrent que les deux groupes ont présenté une amélioration similaire et significative de leurs symptômes et limitations fonctionnelles au fil du temps. Par conséquent, le kinesiotape n’a apporté aucun bénéfice supplémentaire au processus de réadaptation pour réduire les symptômes et les limitations fonctionnelles chez les individus avec TCR à moyen et long terme. De plus, les résultats de l’étude transversale ont montré que le kinesiotape seul a entraîné une augmentation immédiate de la DAH chez les individus avec TCR alors qu’aucun changement immédiat de la capacité proprioceptive chez ces mêmes individus n’a été observé. / Kinesiotaping, an adjunct resource widely used in clinics for treating several musculoskeletal disorders, has been suggested to be effective in immediately reducing pain and functional limitations in individuals with rotator cuff tendinopathy (RCTe) through improvement of the proprioceptive feedback, which may contribute to improving shoulder control. The objective of this thesis was to determine whether kinesiotaping provides additional benefits for the rehabilitation of individuals with RCTe in the mid and long-term. The effectiveness of kinesiotaping in the mid and long-term was investigated when used in conjunction with a 6-week rehabilitation programme based on sensorimotor training for the restoration of shoulder neuromuscular control. To reach our objectives, 52 individuals diagnosed with unilateral RCTe took part in a treatment composed of 10 physiotherapy sessions and home exercises. Participants were randomly assigned to one of two groups (KT [experimental] or No-KT [control]), in which KT group received a therapeutic kinesiotaping application, specific for RCTe, in addition to the rehabilitation programme, whereas No-KT group received only the rehabilitation programme. The physiotherapy rehabilitation programme was the same for both groups, including sensorimotor training, patient re-education, resisted exercises for muscular strengthening, manual therapy, and stretching exercises. An individual rehabilitation plan was customized for each participant. The techniques used varied according to the specific needs of each participant. The level of symptoms and functional limitations were assessed using the Disabilities of the Arm, Shoulder, and Hand (DASH) questionnaire, Brief Pain Inventory (BPI) scores, and the Western Ontario Rotator Cuff (WORC) index, in five-time points (at baseline, week-3, week-6, week-12 and 6-months follow-up), whereas pain-free and full shoulder active range of motion (ROM), and acromiohumeral distance (AHD) at rest and at 60º of active shoulder abduction were evaluated before (baseline) and after the treatment (week-6). In addition, the immediate effect of kinesiotaping in increasing AHD and improving the active joint repositioning ability of individuals with RCTe was also assessed before the first physiotherapy session in the participants of the KT-group (crosssectional design). In general, 78.8% of the participants reported a significant positive change in their shoulder condition at the end of the treatment. The results of the randomized controlled trial (RCT) show that both groups presented a similar and significant improvement of their symptoms and functional limitations over time. Therefore, kinesiotaping did not provide additional benefits to the rehabilitation process for reducing symptoms and functional limitations of individuals with RCTe in the mid- and long-term. In addition, the results of the cross-sectional study showed that kinesiotaping alone provided an immediate increase of AHD in individuals with RCTe, whereas no immediate changes in the proprioceptive ability of these individuals were observed.

No / Intermittent pneumatic compression (IPC) is a mechanical method of delivering compression to swollen limbs that can be used to treat venous leg ulcers and limb swelling due to lymphoedema. This review analyses the evidence for the effectiveness of IPC as a treatment for venous leg ulcers. OBJECTIVES: To determine whether IPC increases the healing of venous leg ulcers. To determine the effects of IPC on health related quality of life of venous leg ulcer patients. SEARCH STRATEGY: We searched the Cochrane Wounds Group Specialised Register (December 2007); the Cochrane Central Register of Controlled Trials (CENTRAL) - The Cochrane Library Issue 4, 2007; Ovid MEDLINE - 2006 to November Week 2 2007; Ovid EMBASE - 2006 to 2007 Week 49 and Ovid CINAHL - 2006 to December Week 1 2007. SELECTION CRITERIA: Randomised controlled studies either comparing IPC with control (sham IPC or no IPC) or comparisons between IPC treatment regimens, in venous ulcer management were included. DATA COLLECTION AND ANALYSIS: Data extraction and assessment of study quality were undertaken by one author and checked by a second. MAIN RESULTS: Seven randomised controlled trials (including 367 people in total) were identified. Only one trial reported both allocation concealment and blinded outcome assessment. In one trial (80 people) more ulcers healed with IPC than with dressings (62% vs 28%; p=0.002). Four trials compared IPC with compression against compression alone. The first of these trials (45 people) found increased ulcer healing with IPC plus compression than with compression alone (relative risk for healing 11.4, 95% Confidence Interval 1.6 to 82). The remaining three trials (122 people) found no evidence of a benefit for IPC plus compression compared with compression alone. One small trial (16 people) found no difference between IPC (without additional compression) and compression bandages alone. One trial compared different ways of delivering IPC (104 people) and found that rapid IPC healed more ulcers than slow IPC (86% vs 61%; log rank p=0.003). AUTHORS' CONCLUSIONS: IPC may increase healing compared with no compression, but it is not clear whether it increases healing when added to treatment with bandages, or if it can be used instead of compression bandages. Rapid IPC was better than slow IPC in one trial. Further trials are required to determine whether IPC increases the healing of venous leg ulcers when used in modern practice where compression therapy is widely used.

O Transplante de Células-Tronco Hematopoéticas (TCTH) trata-se da substituição das Células-Tronco Hematopoéticas (CTH) doentes de um indivíduo por CTH normais com o objetivo de normalizar a hematopoese do receptor. O cateter venoso central (CVC) tornou-se indispensável para viabilizar tal terapêutica pela segurança na infusão das CTH e dos quimioterápicos. Para o TCTH são utilizados cateteres do tipo Hickman ou duplo lúmen, ambos de longa permanência. O curativo adesivo utilizado no sítio de inserção do cateter é essencial para a fixação do cateter, proteção contra agentes externos e prevenção de infecção. Há forte evidência clínica no uso do filme transparente gel de clorexidina (CHX) como uma alternativa no controle de infecções relacionadas ao cateter. A adesividade deste curativo confere-lhe uma possível permanência de até sete dias aderido à pele, o que evita repetidas aplicações e remoções do curativo, diminui a frequência na manipulação do cateter, a ocorrência de infecção e irritação cutânea local. Observa-se que a adesividade do curativo nem sempre permite a permanência por sete dias, sendo necessárias trocas não planejadas, podendo causar lesões à integridade cutânea. Neste estudo, objetivou-se avaliar a adesividade e a irritação cutânea do filme transparente gel de CHX aplicado no sítio de inserção do CVC por meio de um estudo transversal, prospectivo, realizado em um hospital público de ensino, no período de novembro de 2013 a junho de 2014, com crianças e adultos de ambos os sexos com doenças autoimunes ou onco-hematológicas submetidos ao TCTH. A amostra desta pesquisa foi constituída por 25 pacientes. Onze (44%) apresentaram irritação cutânea caracterizada por perda de pele de extensão <=0,5cm, perda de pele de extensão > 0,5cm, placa eritematosa e vesículas. Destes, seis tiveram necessidade de suspensão do uso do curativo. A pele fragilizada devido ao uso de agentes quimioterápicos pode aderir fortemente ao curativo adesivo, sendo desprendida com o mesmo quando este é removido. A perda da integridade cutânea com remoção da camada protetora da pele facilita a entrada de microrganismos aumentando a susceptibilidade a infecções em pacientes imunossuprimidos. Em 55,6% das avaliações foi observado desprendimento do curativo e a região da fenda foi onde mais ocorreu desprendimento (43,4%). Esta é uma região da margem do curativo, assim denominada por possuir uma abertura no adesivo onde são posicionadas as vias do cateter. Infere-se que devido à mobilidade do paciente e manuseio das vias do cateter, com o passar dos dias, essa região da borda do curativo apresenta maior desprendimento. Em 8,4% das observações havia bolha de ar no gel de clorexidina envolvendo o sítio de inserção do cateter. A bolha de ar no gel de clorexidina significa que este não está em contato com a pele do paciente o que é preocupante quando envolve o sítio de inserção do cateter, pois a CHX não está exercendo sua função antisséptica neste local, onde há possibilidade de migração extra- lúmen de microrganismos à corrente sanguínea / Hematopoietic stem cell transplantation (HSCT) involves the replacement of sick hematopoietic stem cells (HSC) from an individual with normal HSC, with the aim to restore the recipient\'s hematopoiesis. Central venous catheters (CVC) have become indispensable to make this therapy feasible due to the safety of infusion of the HSC and the chemotherapeutic agents. In HSCT, long-term Hickman or long-term double lumen catheters are used. The adhesive dressing used in the site of insertion of the catheter is essential for the catheter fixation, protection against external agents and prevention of infection. There is strong clinical evidence on the use of transparent film dressing with chlorhexidine gel (CHX) as an alternative in the control of catheter-related infections. The adhesiveness of this dressing allows it to be used up to seven days once it adheres to the skin, which avoids repeated dressing applications and removals, and reduces the frequency of catheter handling, the occurrence of infection, and local skin rash. However, as observed, the dressing adhesiveness does not always allow it to be used for seven days, and unplanned replacements may be needed, which can cause lesions to the skin integrity. The objective of this study was to evaluate the adhesiveness and skin rash related to the transparent film dressing with CHX gel applied at the site of insertion of the CVC by means of a cross-sectional, prospective study developed at a public teaching hospital, between November 2013 and June 2014, with children and adults of both genders with autoimmune or onco-hematological diseases who were submitted to HSCT. The sample comprised 25 patients. Eleven (44%) presented skin rash characterized by skin loss to an extension of <=0.5 cm, skin loss to an extension of > 0.5 cm, erythematous plaque and vesicles. Of these, six had to interrupt the use of the dressing. Frail skin due to the use of chemotherapeutic agents can adhere strongly to the adhesive dressing, coming off with the dressing at its removal. The loss of skin integrity with the removal of the skin\'s protective layer facilitates the entrance of microorganisms, increasing susceptibility to infections in immunosuppressed patients. In 55.6% of the evaluations, there was dressing detachment, and it was greater in the opening region (43.4%), which is a region in the dressing border with a break in the adhesive where the catheter is placed. Given the mobility of the patient and the handling of the catheter, over the days, this region of the dressing border presents greater detachment. In 8.4% of the observations there were air bubbles in the chlorhexidine gel involving the site of insertion of the catheter. Air bubbles in the chlorhexidine gel means that it is not in contact with the patient\'s skin, which is a cause of concern when the site of insertion of a catheter is involved, since CHX is not exerting its antiseptic function in this location, which can lead to extra-lumen migration of microorganisms to the bloodstream

Made available in DSpace on 2016-08-10T10:57:42Z (GMT). No. of bitstreams: 1 ANA VITORIA ROSA.pdf: 683707 bytes, checksum: d00aaedc3b15de8284e163af46cf4542 (MD5) Previous issue date: 2015-06-29 / Central venous catheters are very important devices in critically ill patients care. However, this device can become a threat to the health of patients, as commonly causes bloodstream infections, especially those most vulnerable. The aim of the study was to evaluate the effectiveness of chlorhexidine-impregnated coatings in central venous catheter ostium in reducing the incidence of catheter-related bloodstream infection. The method used was a systematic review study in a timeframe of eleven years, including the research published in the period from 2004 to 2014, including publications on coatings of central venous catheter ostium in the perspective of the prevention and control of infection, in search of evidences about the effectiveness of using chlorhexidine-impregnated coatings when compared to others coatings in reducing rates of catheter-related bloodstream infection. The search for articles was made through the CINAHL databases, Web of Science, EMBASE, LILACS, MEDLINE and PubMed, using the descriptors and relevant terms to each one. Seventy six publications were identified and eight fulfilled the eligibility criteria. Participants in the studies ranged from 85 to 2302 patients. The use of chlorhexidine-impregnated coating was related to the reduction of the catheterrelated infection rates and catheter-related bloodstream infection rates. The coating with chlorhexidine was well tolerated by participants, however, local reactions such as hyperemia, dermatitis and skin maceration were reported, especially in patients with multiple organ failure, subcutaneous edema or skin integrity impaired, and when remained without dressing change for more than three days. The chlorhexidineimpregnated coating presented advantages and reduction in catheter-related infection rates and in catheter-related bloodstream infection rates when compared to coating without antiseptics, besides representing a best cost-benefit ratio and reduction in mortality rate. / Cateteres venosos centrais são dispositivos de grande relevância no cuidado ao paciente crítico. Entretanto esse artefato poderá se tornar uma ameaça à saúde dos pacientes, já que comumente ocasiona infecções de corrente sanguínea, principalmente naqueles mais vulneráveis. Objetivou-se avaliar a eficácia das coberturas impregnadas com clorexidina em óstio de cateter venoso central na redução da incidência de infecção de corrente sanguínea relacionada a cateter venoso central. Foi realizado um estudo de revisão sistemática, num recorte temporal de onze anos, incluindo as pesquisas publicadas no período de 2004 a 2014, compreendendo as publicações sobre coberturas de óstio de cateter venoso central na perspectiva da prevenção e controle de infecção, em busca de evidências acerca da eficácia do uso da cobertura impregnada com clorexidina quando comparada a outras coberturas na redução das taxas de infecção da corrente sanguínea, relacionada a cateter venoso central. A busca dos artigos se deu por meio das bases de dados CINAHL, Web of Science, EMBASE, LILACS, MEDLINE e PUBMED, utilizando-se os descritores e termos pertinentes a cada uma. Identificouse 76 publicações e foram inclusas oito na revisão, por atenderem aos critérios de elegibilidade. O uso da cobertura impregnada com clorexidina apresentou vantagens e queda nas taxas de infecções quando comparada a outros curativos, estando relacionado a redução das taxas de infecção associada a cateter e das taxas de infecção da corrente sanguínea. A cobertura com clorexidina foi bem tolerada pelos participantes, no entanto, reações locais como hiperemia, dermatites e maceração da pele foram notificadas, principalmente em pacientes com falência múltipla de órgãos, edema subcutâneo e ou com a integridade da pele prejudicada, e quando o curativo permaneceu sem troca por mais de três dias. A cobertura impregnada com clorexidina apresentou vantagens e redução nas taxas de infecção relacionada a cateter e nas taxas de infecção da corrente sanguínea relacionada a cateter quando comparada as coberturas sem antissépticos, além de representar um melhor custo benefício e redução na taxa de mortalidade.

O Transplante de Células-Tronco Hematopoéticas (TCTH) trata-se da substituição das Células-Tronco Hematopoéticas (CTH) doentes de um indivíduo por CTH normais com o objetivo de normalizar a hematopoese do receptor. O cateter venoso central (CVC) tornou-se indispensável para viabilizar tal terapêutica pela segurança na infusão das CTH e dos quimioterápicos. Para o TCTH são utilizados cateteres do tipo Hickman ou duplo lúmen, ambos de longa permanência. O curativo adesivo utilizado no sítio de inserção do cateter é essencial para a fixação do cateter, proteção contra agentes externos e prevenção de infecção. Há forte evidência clínica no uso do filme transparente gel de clorexidina (CHX) como uma alternativa no controle de infecções relacionadas ao cateter. A adesividade deste curativo confere-lhe uma possível permanência de até sete dias aderido à pele, o que evita repetidas aplicações e remoções do curativo, diminui a frequência na manipulação do cateter, a ocorrência de infecção e irritação cutânea local. Observa-se que a adesividade do curativo nem sempre permite a permanência por sete dias, sendo necessárias trocas não planejadas, podendo causar lesões à integridade cutânea. Neste estudo, objetivou-se avaliar a adesividade e a irritação cutânea do filme transparente gel de CHX aplicado no sítio de inserção do CVC por meio de um estudo transversal, prospectivo, realizado em um hospital público de ensino, no período de novembro de 2013 a junho de 2014, com crianças e adultos de ambos os sexos com doenças autoimunes ou onco-hematológicas submetidos ao TCTH. A amostra desta pesquisa foi constituída por 25 pacientes. Onze (44%) apresentaram irritação cutânea caracterizada por perda de pele de extensão <=0,5cm, perda de pele de extensão > 0,5cm, placa eritematosa e vesículas. Destes, seis tiveram necessidade de suspensão do uso do curativo. A pele fragilizada devido ao uso de agentes quimioterápicos pode aderir fortemente ao curativo adesivo, sendo desprendida com o mesmo quando este é removido. A perda da integridade cutânea com remoção da camada protetora da pele facilita a entrada de microrganismos aumentando a susceptibilidade a infecções em pacientes imunossuprimidos. Em 55,6% das avaliações foi observado desprendimento do curativo e a região da fenda foi onde mais ocorreu desprendimento (43,4%). Esta é uma região da margem do curativo, assim denominada por possuir uma abertura no adesivo onde são posicionadas as vias do cateter. Infere-se que devido à mobilidade do paciente e manuseio das vias do cateter, com o passar dos dias, essa região da borda do curativo apresenta maior desprendimento. Em 8,4% das observações havia bolha de ar no gel de clorexidina envolvendo o sítio de inserção do cateter. A bolha de ar no gel de clorexidina significa que este não está em contato com a pele do paciente o que é preocupante quando envolve o sítio de inserção do cateter, pois a CHX não está exercendo sua função antisséptica neste local, onde há possibilidade de migração extra- lúmen de microrganismos à corrente sanguínea / Hematopoietic stem cell transplantation (HSCT) involves the replacement of sick hematopoietic stem cells (HSC) from an individual with normal HSC, with the aim to restore the recipient\'s hematopoiesis. Central venous catheters (CVC) have become indispensable to make this therapy feasible due to the safety of infusion of the HSC and the chemotherapeutic agents. In HSCT, long-term Hickman or long-term double lumen catheters are used. The adhesive dressing used in the site of insertion of the catheter is essential for the catheter fixation, protection against external agents and prevention of infection. There is strong clinical evidence on the use of transparent film dressing with chlorhexidine gel (CHX) as an alternative in the control of catheter-related infections. The adhesiveness of this dressing allows it to be used up to seven days once it adheres to the skin, which avoids repeated dressing applications and removals, and reduces the frequency of catheter handling, the occurrence of infection, and local skin rash. However, as observed, the dressing adhesiveness does not always allow it to be used for seven days, and unplanned replacements may be needed, which can cause lesions to the skin integrity. The objective of this study was to evaluate the adhesiveness and skin rash related to the transparent film dressing with CHX gel applied at the site of insertion of the CVC by means of a cross-sectional, prospective study developed at a public teaching hospital, between November 2013 and June 2014, with children and adults of both genders with autoimmune or onco-hematological diseases who were submitted to HSCT. The sample comprised 25 patients. Eleven (44%) presented skin rash characterized by skin loss to an extension of <=0.5 cm, skin loss to an extension of > 0.5 cm, erythematous plaque and vesicles. Of these, six had to interrupt the use of the dressing. Frail skin due to the use of chemotherapeutic agents can adhere strongly to the adhesive dressing, coming off with the dressing at its removal. The loss of skin integrity with the removal of the skin\'s protective layer facilitates the entrance of microorganisms, increasing susceptibility to infections in immunosuppressed patients. In 55.6% of the evaluations, there was dressing detachment, and it was greater in the opening region (43.4%), which is a region in the dressing border with a break in the adhesive where the catheter is placed. Given the mobility of the patient and the handling of the catheter, over the days, this region of the dressing border presents greater detachment. In 8.4% of the observations there were air bubbles in the chlorhexidine gel involving the site of insertion of the catheter. Air bubbles in the chlorhexidine gel means that it is not in contact with the patient\'s skin, which is a cause of concern when the site of insertion of a catheter is involved, since CHX is not exerting its antiseptic function in this location, which can lead to extra-lumen migration of microorganisms to the bloodstream