title: Surgical treatment of persistent exit-site infections.
abstract: Persistent exit-site infections and tunnel infections (ESI/TI) are a cause for removal of Swan neck catheters (SNC). Previous studies report variable success in the treatment of these infections by surgical exposure and removal of the subcutaneous external cuff. We report our experience with this technique. All 5 patients with persistent ESI/TI were successfully treated with antibiotics and surgical intervention. All cultures grew Staphylococcus aureus. Average time to complete healing after surgical exposure was 39.4 days. Mean follow-up after complete healing was 164.8 days. There were no subsequent episodes of ESI/TI in these patients. None of the catheters subsequently malfunctioned or developed leaks. Persistent ESI/TI in Swan neck catheters can be successfully treated with surgical exposure and removal of the subcutaneous external cuff.
authors.affiliation: Pennsylvania Hospital, Philadelphia, USA.
authors.forename: J D
authors.initials: JD
authors.lastname: Glickman
authors.forename: T
authors.initials: T
authors.lastname: Rafanello
authors.forename: R E
authors.initials: RE
authors.lastname: Gerhardt
authors.forename: K A
authors.initials: KA
authors.lastname: Ntoso
authors.forename: J D
authors.initials: JD
authors.lastname: Koethe
authors.forename: C J
authors.initials: CJ
authors.lastname: Wolf
authors.forename: J
authors.initials: J
authors.lastname: Polsky
mesh_terms: D000900:Anti-Bacterial Agents / Q000008:administration & dosage; D002408:Catheters, Indwelling; D003131:Combined Modality Therapy; D003646:Debridement; D006801:Humans; D007676:Kidney Failure, Chronic / Q000601:surgery*; D010530:Peritoneal Dialysis / Q000295:instrumentation*; D013530:Surgical Wound Infection / Q000601:surgery*; D014945:Wound Healing / Q000187:drug effects
chemical_list: D000900:Anti-Bacterial Agents