What type of dressing is used for peripheral IV site? A Comprehensive Guide

September 28, 2025 •

5 min read

With hundreds of millions of peripheral intravenous (IV) catheters used annually in acute care settings, proper site care is crucial for patient safety. A key component of this care is understanding what type of dressing is used for peripheral IV site, a choice that can significantly impact the risk of complications such as infection and dislodgment.

Quick Summary

Peripheral IV sites are most commonly covered with sterile, transparent film dressings, which provide a protective barrier while allowing for easy visual assessment of the insertion site. Specialized transparent dressings that are impregnated with chlorhexidine gluconate are also used to reduce infection risk, particularly for central lines, and are being increasingly applied for peripheral IVs. Other options like sterile gauze and tape may be used depending on patient needs, such as for weeping or heavily moist sites.

Key Points

Dressing Type: Transparent film dressings are the standard for peripheral IV sites due to their protective barrier and ability to allow for continuous site monitoring.
Antimicrobial Option: Specialized transparent dressings containing chlorhexidine gluconate (CHG) are used to further reduce the risk of catheter-related infections, especially for higher-risk patients.
Gauze Usage: Gauze and tape are generally reserved for specific situations, such as bleeding or moist sites, as they obscure visibility and require more frequent changes.
Securement is Key: Beyond the dressing, securing the catheter with additional strips or an engineered stabilization device is essential to prevent dislodgment and vein irritation.
Assess and Replace: The IV site must be regularly inspected for complications like infiltration or phlebitis, and the dressing should be changed immediately if it is loose, soiled, or damp, or routinely per policy.
Proper Technique: Meticulous aseptic technique during insertion and dressing application is critical to minimize the risk of infection at the insertion site.
Consider Patient Needs: Factors like skin condition, perspiration, and the duration of therapy all influence the choice of the most suitable dressing.

The Primary Functions of a Peripheral IV Dressing

A peripheral IV dressing is not simply a bandage; it serves several critical purposes in patient care. Its main functions are to secure the catheter in place, protect the insertion site from external contaminants, and, in some cases, provide a clear window for visual inspection. Without a proper dressing, the catheter is vulnerable to accidental dislodgment and the site is at a higher risk of infection, potentially leading to more serious bloodstream infections.

Catheter Securement

One of the most important jobs of a dressing is to immobilize the catheter. Movement at the insertion site can cause irritation to the vein wall (phlebitis), damage to the vessel, or even cause the catheter to become partially or completely dislodged. Minimizing catheter pistoning, or small in-and-out movements, helps prevent this irritation and the potential entry of microorganisms along the catheter track.

Barrier Against Contamination

The skin is a natural protective barrier, but a catheter insertion compromises this defense. A sterile dressing creates a sealed barrier, protecting the wound from bacteria, viruses, and environmental dirt. This is particularly important for preventing microorganisms from migrating from the skin surface into the bloodstream.

Visual Assessment of the Site

Clear or transparent dressings are particularly beneficial as they allow healthcare providers to continuously monitor the IV site without removing the dressing. This visibility is essential for the early detection of complications such as redness (erythema), swelling (edema), or leakage, which can indicate issues like infiltration or phlebitis.

Types of Peripheral IV Dressings in Clinical Use

Several types of dressings are available, and the choice depends on clinical assessment, patient needs, and facility protocols. Here are the most common options:

Transparent Film Dressings (TFDs)

These are the most widely used dressings for peripheral IVs. They are typically made of a sterile, adhesive polyurethane film that is moisture-responsive, allowing moisture vapor to escape while remaining waterproof to protect the site.

Advantages: Excellent visibility of the site, effective barrier against bacteria, breathable, can be worn for up to 7 days, and is waterproof for showering.
Disadvantages: May not adhere well to diaphoretic (sweaty) or weeping sites, and some patients may experience skin irritation from the adhesive over time.

Antimicrobial Transparent Dressings

These are TFDs that incorporate a chlorhexidine gluconate (CHG) gel pad or are impregnated with CHG in the adhesive. CHG is a powerful antiseptic agent that provides continuous antimicrobial protection at the insertion site.

Advantages: Clinically proven to reduce catheter-related bloodstream infections (CRBSIs) in central lines and increasingly used for peripheral IVs to bolster infection prevention efforts.
Disadvantages: Higher cost compared to standard TFDs and contraindicated for patients with known CHG sensitivity.

Sterile Gauze and Tape Dressings

This traditional dressing consists of sterile gauze held in place with medical tape. While still used, it has largely been replaced by transparent films for peripheral IVs in most modern settings.

Advantages: Highly absorbent, making it suitable for moist or bleeding sites. Less expensive in some cases.
Disadvantages: Obscures the site, requiring frequent removal and reapplication for inspection, which increases the risk of dislodgment and skin trauma. Gauze that becomes damp can also create a breeding ground for microorganisms.

Engineered Stabilization Devices (ESDs)

These devices are used alongside a standard transparent film dressing to provide superior catheter stabilization compared to tape alone. They feature secure anchor points that reduce catheter movement and the risk of accidental dislodgment.

Advantages: Significantly improves securement and helps prevent micro-motion of the catheter within the vein, which can cause mechanical phlebitis.
Disadvantages: Increased cost and may require specialized training for application.

Comparison of Peripheral IV Dressings


Feature	Transparent Film Dressings	Antimicrobial CHG Dressings	Sterile Gauze and Tape
Visibility	Excellent (allows continuous monitoring)	Excellent (with CHG gel pad)	None (site must be uncovered to inspect)
Adherence	Good, but can lift with moisture or sweat	Excellent, especially moisture-responsive films	Varies by tape quality; poor in humid conditions
Antimicrobial	None	Continuous protection via CHG	None (gauze can become contaminated)
Wear Time	Up to 7 days, or until soiled/loose	Up to 7 days	Short-term, requires frequent changes
Cost	Moderate	Higher than standard films	Often perceived as cheaper, but total cost can be higher due to frequent changes and potential complications

Proper Application and Maintenance

Applying a dressing correctly is just as important as choosing the right one. The process must be meticulous to maintain sterility and ensure the catheter is secure. A typical procedure involves:

Site Preparation: After selecting the vein and inserting the catheter, the site is thoroughly disinfected with an antiseptic solution, such as 2% alcoholic chlorhexidine, and allowed to air dry completely.
Application: The transparent film or other dressing is carefully centered over the insertion site. For TFDs, the frame is typically peeled away while smoothing the dressing firmly from the center outwards to ensure good adhesion and prevent wrinkles.
Securement: Additional securement strips or an ESD may be applied to stabilize the catheter hub and loop the tubing, reducing the risk of pulling and dislodgment.
Documentation: The dressing and insertion site are labeled with the date, time, and initials of the person who placed it.

Assessing the IV Site and When to Replace a Dressing

Regularly assessing the IV site is crucial. With transparent dressings, this can be done visually. The dressing should be replaced immediately if it becomes damp, loose, or soiled. Otherwise, transparent dressings can remain in place for up to 7 days, or according to facility policy. Gauze and tape dressings typically need more frequent changes, often every 2 days.

Signs of complications to watch for include:

Infiltration: Fluid leaks into the surrounding tissue. Look for swelling, coolness, or blanching at the site.
Phlebitis: Inflammation of the vein, often accompanied by redness, swelling, tenderness, or a palpable cord along the vein path.
Infection: Signs include increased redness, warmth, pain, or purulent drainage from the site.
Dislodgment: The catheter is pulled out of the vein, causing leakage or malfunction.

For more detailed, evidence-based recommendations on catheter care, the Centers for Disease Control and Prevention (CDC) provides extensive guidelines for healthcare professionals and is an excellent reference: CDC Recommendations for Intravenous Catheter Care.

Conclusion

The most appropriate dressing for a peripheral IV site is typically a sterile, transparent film dressing. These dressings offer the best combination of site protection, visibility, and longevity. The use of antimicrobial dressings or enhanced securement devices provides additional layers of protection for patients at higher risk of complications. Ultimately, the correct choice, along with meticulous application and frequent assessment, is vital for preventing complications and ensuring safe, effective intravenous therapy.

Frequently Asked Questions

The most common type of dressing used for a peripheral IV site is a sterile, transparent film dressing. This dressing allows for continuous visual inspection of the site while providing a sterile barrier against external contaminants.

Transparent dressings are often preferred over gauze because they allow healthcare providers to see the IV site without removing the dressing. This reduces the risk of infection and accidental dislodgment that can occur during dressing changes. They are also waterproof, allowing patients to shower, and can be left in place for up to 7 days.

A CHG dressing is a transparent film dressing that includes a chlorhexidine gluconate gel pad or is impregnated with the antimicrobial agent in the adhesive. While traditionally used for central lines, it is also increasingly used for peripheral IVs to further reduce the risk of infection, especially in high-risk patients.

A transparent film dressing should be changed at least every 5 to 7 days, unless it becomes soiled, damp, or starts to lift. Gauze dressings, however, must be changed more frequently, typically every 2 days or when moisture is present.

When checking your IV site, you should look for signs of complications. These include redness (erythema), swelling (edema), warmth, tenderness, pain, or any leakage of fluid. If a clear dressing is used, you can check for these signs visually. If any of these are present, a healthcare provider should be notified.

A secure IV dressing is vital to prevent the catheter from moving or being accidentally dislodged from the vein. Catheter movement can cause mechanical phlebitis (vein irritation) or allow bacteria to enter the bloodstream. Proper securement minimizes these risks and protects the insertion site.

If your IV dressing becomes loose or starts to peel away from the skin, it no longer provides a sterile barrier and can increase the risk of infection. You should contact your healthcare provider or nurse immediately to have it replaced, as it's crucial to maintain the integrity of the dressing seal.