We have developed a two-step procedure for preparing the skin before peripheral venous
catheter (
PVC) insertions. This procedure involves two successive swabbings with wipes soaked in alcoholic
antiseptic. We investigated whether this two-step procedure was as effective and safe as the standard four-step procedure--washing with
detergent, rinsing, drying, applying
antiseptic--by carrying out a multicentre randomised equivalence study comparing the frequency of precursor signs of
infection at the site of insertion for the two skin preparation procedures. The study was carried out over an eight-month period, and 248
PVC insertion sites were evaluated. The two-step procedure was used for 130 subjects and the standard procedure for 118. Taking into account all the confounding factors predisposing patients to the complications studied, the characteristics of the two groups of patients were found to be similar, with no significant differences noted. The incidence of precursor signs of
infection was 11% 24 hours after
PVC insertion (27/248), 25% at 48 hours (50/203) and at 29% at 72 hours (34/119). Eleven patients had complications necessitating the withdrawal of the
PVC: sensitivity of the insertion site, with redness and/or slight swelling and/or a palpable venous cord. No major complications were observed in this study. The frequency of local complications associated with PVCs reported in this study, whether simple or severe, was not affected by the skin preparation procedure used for
PVC insertion (two-step or four-step procedure).