Objectives: Review the literature on best dressing practice in reducing incidence of catheter-related infections in patients receiving haemodialysis, and explore the evidence specifically related to tropical climates.

Methods: Electronic database searches were conducted [MD Consult, Blackwell, Cochrane, Ovid, Medline, CINAHL] in relation to central venous catheters (CVC), with the specific search terms: central venous catheter; haemodialysis; tropics; exit site; dressing; transparent; primapore, IV3000; sepsis.

Results: 152 articles were initially retrieved. Of these, only 12 review and 9 research articles were relevant to the topic objective as most were based on CVC care generally, and did not specifically relate to exit site dressings. Exit site dressing articles predominantly compared gauze to transparent dressings. The evidence of a causal relationship between transparent dressings and risk of catheter-related bloodstream infections is inconclusive. Transparent dressings increase the risk of catheter tip colonisation and promote moisture and bacterial proliferation on peripheral cannulation sites. No articles addressed CVC management in the tropical context.

Conclusions: There is some evidence to suggest infection rates are higher using transparent compared to gauze dressings, although insufficient information is available regards using gauze dressings on CVC sites. Strict aseptic techniques are warranted in the placement and care of CVC sites. No studies were found that investigated the effectiveness of either dressing type, or an appropriate dressing protocol, for the tropics.

Recommendations: Further investigation is required in the tropics to determine the most effective dressing type and dressing protocol for use on haemodialysis central venous exit sites.