Suprapubic and Clean Intermittent Self-Catheterisation

Table of Contents

1. Introduction
2. Indications for suprapubic and intermittent catheterisation
   1. Suprapubic catheters
   2. Intermittent Catheterisation
3. Risks and complications of suprapubic catheters
4. Care and management of suprapubic catheters
   1. Managing the abdominal wound
5. Changing a suprapubic catheter
   1. Managing bypassing and suprapubic catheter blockage
6. Teaching patients to self-catheterise
   1. Frequency of catheterisation
7. Product choice
   1. Other information needs
8. Summary
9. References

Managing the abdominal wound

Following insertion the patient will have an abdominal wound, which may become infected. These wounds commonly exude a mucopurulent discharge, which can be managed by cleaning locally around the catheter. This does not necessarily indicate that the wound has become infected. Dressings may be used initially, but are not recommended in the long term (RCN, 2008). After a few days the dressing should be removed as these may encourage over-granulation and the skin around the insertion site cleaned during normal bathing.

Task 8

1

When would antibiotics be indicated for treatment of a suspected wound infection? Enter your answer in the box below and then select Check answer. If cellulitis is present around the insertion site and the patient is showing signs of infection, e.g. pyrexia, then systemic antibiotics would be indicated.

Exudate around the wound puts the patient at risk of moisture associated skin damage (Voegeli, 2012).

Task 9

2

How should moisture associated skin damage be prevented? Enter your answer in the box below and then select Check answer. The correct answers are the following: - Gentle cleansing of surrounding skin using pH neutral skin cleansers - Moisturisation of the skin - Protection using an appropriate barrier

Over-granulation is another problem that can commonly occur at the wound site. The patient has a wound, after all, that is being kept open by the catheter and the body is trying to heal.

Task 10

3

How should over-granulation be managed? Enter your answer in the box below and then select Check answer. Silver nitrate sticks can be used to cauterise granulation tissue if this forms around the catheter (Harrison et al, 2010). A barrier cream should be applied to healthy skin to prevent damage from the application of silver nitrate.