Winner — AANA’s 2026 Rm8 iNoV8 Pitch Competition First place at the American Association of Nurse Anesthesiology Annual Congress, Boston

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Central line dressing protection

A protective cover for central line dressings.

The dressing isn’t the problem. Keeping it intact is.

It goes on over the dressing that’s already there. When something spills, soaks, or snags, you replace the cover instead of the dressing.

What it is
A transparent, non-sterile overlay applied on top of an existing central line dressing. It is not a dressing and not a securement device — it protects the dressing you already use.
Why it’s used
Central line dressings are meant to last seven days. Most don’t. MudFlap takes the mess so the dressing underneath stays clean, dry, and intact — and it lifts off without pulling that dressing up with it.
Patent pending · US & PCT Invented by a bedside nurse
Annotated diagram of MudFlap: non-adhesive region shown as a dotted outline, a clear window for visibility of the underlying dressing, a perforated top flap for easy tear and removal, the top flap adhering over the bottom flap, and the exit hole and line covered beneath the top flap.
Small / Pediatric size: 5.125 × 4.00 in (130.18 × 101.60 mm).
The problem

Dressings are meant to last seven days. Most don't.

Two-thirds are changed before their planned date — soiled, wet, or lifted. In the ICU most of those changes are unplanned, and every one means opening the sterile field again.

67% of dressing changes occurred before the planned date Timsit et al., Crit Care Med, 2012
>10× catheter-related bloodstream infection risk when the final dressing was disrupted Timsit et al., 2012
+140% increase in dressing lifespan from a dressing-integrity bundle (2.7 → 6.5 days) Gaskill et al., QI study, 2024
$46–70K estimated excess cost per CLABSI case — the most expensive HAI in US hospitals AHRQ / CDC-anchored estimates

Nurses already improvise ways to prevent it. Every method has a specific failure mode.

ApproachWhere it breaks down
A second transparent film dressing
laid over the first
Adhesive across its whole face, so it bonds to the dressing underneath. Removing it lifts the dressing off — the exact event you were preventing.
Improvised barriers
(cut drape, plastic wrap, tucked chux)
No standard size, no catheter exit, no reliable seal. Quality depends on who taped it and how much time they had.
Change the dressing more often The default today. Every change is another sterile procedure, more adhesive on fragile skin, and more site manipulation.
MudFlap Purpose-built: adhesive at the border, non-adhesive center, defined catheter exit, perforated flap. Same application, every shift.
The fix

Change the overlay, not the dressing.

MudFlap takes the spill, the soak, and the snag. When it’s soiled you swap the overlay — the sterile dressing underneath is never opened.

Today

Soiled dressing → full sterile change

  • Gather a full central line dressing kit
  • Remove the soiled dressing from fragile skin
  • Re-prep and re-dress the insertion site, sterile
  • Restart the seven-day clock
  • Document the unscheduled change
With MudFlap

Soiled overlay → swap the overlay

  • Peel off the soiled MudFlap
  • Primary dressing stays undisturbed underneath
  • Apply a fresh MudFlap
  • Seven-day clock keeps running
  • No sterile field opened

The difference is what happens on removal.

A second transparent film dressing

A standard transparent film dressing — adhesive across its entire face.

It bonds to the dressing underneath. Pulling it off lifts the dressing with it — and the sterile field has to be opened.

MudFlap

Adhesive at the border only. Nothing sticks to the dressing.

It lifts away clean. The dressing stays put, and its seven-day clock keeps running.

MudFlap also perforates its top flap, so it tears to free the catheter rather than being dragged along it. This is the single design decision the whole product turns on.

The device

Four decisions, each aimed at a known failure mode.

  • 1
    A non-adhesive region over the dressing The dotted outline marks the area with no adhesive at all. It spans the primary dressing without bonding to it, so removing MudFlap can’t lift, tear, or drag the dressing underneath.
  • 2
    A clear window for visibility The insertion site and the dressing beneath stay visible for inspection without removing anything — the continuous-visualization requirement is preserved, not traded away.
  • 3
    A bottom flap that threads under the catheter The bottom flap passes beneath the line and adheres to skin, building a clean base around the exit instead of trapping the catheter under film.
  • 4
    A perforated top flap that seals over it The top flap adheres over the exit site and the bottom flap, covering the most exposed edge — the one facing the diaper. Its perforation lets the nurse tear it to free the catheter on removal, rather than dragging the whole part along the line.
The thesis

MudFlap acts on the first link in a chain the literature has already mapped.

MudFlap does not treat infection. It intervenes upstream, on the disruption event — and disruption is where the published evidence is strongest. Here is the full chain, with an honest mark on every link.

  1. 1
    The overlay absorbs the insult instead of the dressing

    Stool, urine, secretions, moisture, and mechanical wear land on a removable non-sterile overlay rather than on the sterile dressing.

    Design intent — bench testing pending
  2. 2
    Fewer disruption events reach the primary dressing

    The dressing stays clean, dry, and intact closer to its intended seven-day life. The response to a soiled surface becomes an overlay swap, not a sterile change.

    Not yet demonstrated for MudFlap
  3. 3
    Dressing integrity is a major, addressable risk factor

    Two-thirds of dressing changes happen before the planned date. Two or more disruptions carried more than triple the catheter-related bloodstream infection risk; a disrupted final dressing, more than tenfold.

    Established in the literature
  4. 4
    Improving integrity measurably improves outcomes

    A dressing-integrity bundle improved integrity by roughly a third and more than doubled dressing lifespan. Liquid adhesive cut premature jugular dressing failure from 50% to 28%. Integrity is a lever that responds.

    Established in the literature
Patient

Indirect infection-risk reduction

MudFlap makes no infection claim. The argument is structural: if the device reduces disruption events, it acts on a risk factor the literature has already tied to infection. Proving that it does is the next milestone, not a claim we make today.

Nursing

Time returned to the bedside

A full central line dressing change is a sterile, multi-step procedure: gather the kit, remove the old dressing, re-prep the site, re-dress, document. Swapping a non-sterile overlay is a fraction of that, and it doesn't need a second set of hands.

Hospital

Fewer kits, less rework

Every unplanned change consumes a full dressing kit and nursing hours that were allocated elsewhere. A low-cost consumable that displaces some share of those changes is a favorable trade before any infection benefit is counted.

Research

What the literature shows, and what it doesn't.

The figures cited on this page come from the published literature on central line dressings. None of them are studies of MudFlap.

Where the evidence stands

The mechanism and the unmet need are well documented, and the figures above come from that published record. MudFlap’s own outcome data is the next body of work: fluid-challenge and durability testing on the bench, then clinical evaluation. We’d rather show you that data than claim it early.

Regulatory. MudFlap is moving through the FDA process now, working with regulatory counsel. As a non-sterile protective accessory that makes no therapeutic claim, we anticipate a Class I pathway, subject to confirmation. MudFlap is not yet FDA cleared or approved and is not available for sale.

Where it stands

Protected, recognized, and in process.

Intellectual property

Patent pending, US and international

A US prioritized utility application and an international PCT application are on file, prosecuted by Husch Blackwell, following a professional prior art search. Foreign market rights are preserved.

Recognition

First place, AANA’s Rm8 iNoV8 Pitch Competition

First place, selected from five finalists at the American Association of Nurse Anesthesiology Annual Congress in Boston, 2026 — with continued development support through Rm8, AANA’s innovation lab.

Product

Manufactured prototypes in hand

Multiple design revisions with a contract converter, converging on a laminate construction with a polyurethane window and a three-part release liner — iterated throughout against feedback from working nurses.

Regulatory

In process with FDA counsel

Classification and submission route are being determined with regulatory counsel. As a non-sterile protective accessory making no therapeutic claim, a Class I pathway is anticipated.

Next

Bench testing, then clinical evaluation

Fluid-challenge and durability testing, followed by clinical evaluation to generate MudFlap’s own outcome data.

Open

Partnership

Actively looking for the manufacturing, distribution, or licensing partner to take this to scale. Get in touch.

Origin
Where it came from

It almost always happened at two in the morning.

A central line dressing is supposed to stay clean, dry, and intact for up to seven days. In the ICU, that almost never happens.

A femoral line gets soiled through a diaper. A neck line gets wet from oral secretions or a leaking tube. Something catches on a blanket during a turn. And every single time, the answer is the same: change the dressing.

That means opening the sterile field again. More tape on skin that's already fragile. Another twenty minutes out of a night that didn't have twenty minutes in it. And it's almost never planned — the literature puts unscheduled changes at the majority of them.

Every piece of innovation had gone into making a better dressing. Nobody had built anything to protect the dressing once it was on.

That's the whole idea. We're not trying to improve the dressing. We're trying to protect the one that's already there, so it can last as long as it was designed to.

Brett Garcia
Founder
Brett Garcia, BSN, RN, RRNA
Founder · BCG Clinical Solutions LLC

Brett spent his bedside career as a pediatric intensive care nurse at Cook Children's, where central line dressings were a daily, unglamorous problem. He is now a nurse anesthesia resident at Texas Christian University.

MudFlap came out of that experience rather than a market analysis. The design has been shaped throughout by feedback from the nurses who would actually be applying it — because a device that's awkward to handle at 2am is a device that doesn't get used.

MudFlap is developed by BCG Clinical Solutions LLC. Patent counsel: Husch Blackwell LLP.

Get in touch

Let's talk.

MudFlap is looking for the right partners to take a simple device to the bedside at scale.