Shower pouches - who uses them? do you have local data for or against? or detailed literature review?

We advise patients against showering with TCVC - particularly when skin has not yet healed up. However, patients consider ability to shower as important to them. (Patient and Health Care Provider Perspectives on Showering for Patients With Hemodialysis Central Venous Catheters: A Survey Study - PubMed)

Shower pouches are commercially available. Company reps often hand these out to our patients, who then ask GPs to prescribe them. There has been more reluctance to do so recently though, due to high cost and limited evidence. I can see some boards have advised against prescribing:

"NHS South West London (SWL) and SWL Renal specialists do not support the routine prescribing of shower protection pouches and auxiliary products for patients on dialysis due to a lack of evidence and increased risk of infection. 2024."

"Norfolk and Waveney ICB do not support the routine prescribing of shower/swim protection pouches and auxiliary products for patients on dialysis due to a lack of evidence  and increased risk of infection. Oct 2025."

Evidence I've found so far:

• Nguyen, Duc B. et al. “Hemodialysis-Associated Infections.” Chronic Kidney Disease, Dialysis, and Transplantation (2019): 389–410.e8. doi:10.1016/B978-0-323-52978-5.00025-2 (accessed 28/10/2025)  
• Prevention of Bloodstream Infections in Patients Undergoing Hemodialysis - PMC - review, no firm evidence
• No international guidelines mention beyond: kdoqi_vasc-access-review2019_v2.pdf  "Catheter dressings should be protected against wet and dirty environments, particularly when the exit site is not yet fully healed (e.g. avoid swimming and unprotected showering)”

So, who uses them? do you have local data for or against? or detailed literature review you can share?