Abstract

Exit-site infection (ESI), tunnel infection and associated peritonitis are major causes of morbidity and catheter loss in chronic peritoneal dialysis patients. Meticulous exit-site care is vital in preventing ESI. Avoiding trauma to the exit-site and daily cleaning of the exit-site with a dedicated antimicrobial soap is essential for the longevity of the peritoneal dialysis catheter. Antibiotics cream and disinfectant agents including povidone-iodine, chlorhexidine, electrolytic chloroxidizing solutions (Amuchina 10% - ExSept Plus, Amuchina 5% -ExSept) are useful to keep the resident micro-organisms inhibited. ESI rates in peritoneal dialysis patients treated with Amuchina 10% (ExSept Plus) and Amuchina 5% (ExSept) for the exit-site care are similar or lower compared to povidone-iodine or chlorhexidine. Electrolytic chloroxidizing (Amuchina 10% - ExSept Plus and Amuchina 5% - ExSept) solutions for exit-site care are effective for prevention and treatment of ESI.

Copyright © 2007 S. Karger AG, Basel

Access to the peritoneal cavity using an indwelling permanent and trouble-free catheter is a key factor in the success of peritoneal dialysis (PD). However, catheter exit-site infection (ESI) and tunnel infection (TI) remain the major cause of increased morbidity, prolonged antibiotic therapy, recurrent peritonitis, and catheter failure. The frequency of infection can be reduced by scrupulous exit-site care. Exit-site care begins even before the catheter is implanted. The ultimate goal of the exit-site care is to keep the exit-site clean, dry, scab-free, crust-free, and painless and non-inflamed [1, 2]. The PD exit-site care will be discussed as below in this chapter:

(1) Exit-site care pre-implantation of PD catheter.

(2) Early exit-site care post-implantation during healing phase.

(3) Chronic exit-site care of healed exit-site.

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