Central venous access device-related skin injuries for children receiving cancer treatment: A scoping review

Abstract

Central venous access devices (CVADs) play a vital role in the administration of anti-cancer therapy; however, skin injuries surrounding insertion sites can develop, resulting in pain and device failure. This review aimed to synthesise and critically appraise studies describing skin injuries related to CVADs in children being treated for cancer. This integrative literature review follows established methodology by Whittemore and Knafl’s (2005) guidelines. Studies were included if they had paediatric participants (from birth to 18 years), being treated for a solid or haematological cancer, where the study outcomes measured skin integrity at the CVAD sites. Three databases (MEDLINE, Embase and CINAHL) yielded 613 articles, with six studies meeting the inclusion criteria. Exit site infection ranged from 2.35 per 1000 catheter days to 0 per 1000 catheter days. The rate of skin injury and complications are observed to be as high as 16% for exit site infection and 11% for dermatitis. Infection is an important outcome, but not the sole outcome to consider during CVAD site observation. Often a lack of knowledge and awareness of skin injury can cause device complications and failure which has a negative impact on paediatric cancer patients.