Cuff-shaving procedure. A rescue treatment for exit-site infection unresponsive to medical therapy.
We performed 41 cuff-shaving procedures in 38 patients on continuous ambulatory peritoneal dialysis (CAPD) with exit-site infection unresponsive to medical treatment. Cuff shaving was performed on three patients with two catheters each. This procedure was effective in eliminating 50% of S. aureus exit-site infection and all S. epidermidis exit-site infection, but was ineffective in Gram-negative exit-site infection. After cuff-shaving procedure, 20 catheters (49%) were removed; 11 for persistent tunnel infection and nine because of development of secondary peritonitis. The probability of catheter survival at 1 year was 50% and remained stable thereafter. Cuff-shaving procedure may be a valuable mode of therapy for treating patients with S. aureus and/or S. epidermidis exit-site infection unresponsive to medical treatment.
Scalamogna
A
A
Division of Nephrology and Dialysis, Ospedale Maggiore, Milan, Italy.
De Vecchi
A
A
Maccario
M
M
Castelnovo
C
C
Ponticelli
C
C
D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D002408:Catheters, Indwelling / Q000009:adverse effects* / Q000382:microbiology; D005260:Female; D006090:Gram-Negative Bacteria / Q000302:isolation & purification; D006801:Humans; D007676:Kidney Failure, Chronic / Q000150:complications / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D010531:Peritoneal Dialysis, Continuous Ambulatory; D010538:Peritonitis / Q000382:microbiology* / Q000628:therapy; D013210:Staphylococcus / Q000302:isolation & purification
D000900:Anti-Bacterial Agents