Merit of the cuff-shaving procedure in children with chronic infection.
Catheter replacement and cuff-shaving are per-formed as a surgical treatment against tunnel infection(TI) in patients on chronic peritoneal dialysis. The efficacy of catheter replacement is well established, but that of cuff-shaving is not. For the purpose of evaluating the efficacy of cuff-shaving, we compared the time interval between each procedure and subsequent TI. In order to perform this comparison, we reviewed data from 32 cuff-shaving procedures and 29 catheter replacement procedures at Tokyo Metropolitan Kiyose Children's Hospital in the period from 1 March 1991 to 1 May 2001, retrospectively. There was no significant difference in the time interval between each procedure and subsequent TI(P=0.284). The incidence of recurrence was no more than 12.5% for the cuff-shaving procedures. The incidence of peritonitis due to post-surgery TI with the cuff-shaving procedures was 9.3% and 6.8% with the replacement procedure (P=0.725). There was no significant variation in time interval to post-cuff-shaving TI according to the reason for the cuff-shaving procedure. In conclusion,cuff-shaving may be worth considering for TI in adequately selected patients.
Yoshino
Atsunori
A
Department of Pediatrics, Dokkyo University School of Medicine, Koshigaya Hospital, Saitama, Japan. ayoshino@dokkyomed.ac.jp
Honda
Masataka
M
Ikeda
Masahiro
M
Tsuchida
Satoko
S
Hataya
Hiroshi
H
Sakazume
Satoru
S
Tanaka
Yuriko
Y
Shishido
Seiichiro
S
Nakai
Hideo
H
D000293:Adolescent; D002404:Catheterization / Q000009:adverse effects* / Q000295:instrumentation; D002408:Catheters, Indwelling / Q000009:adverse effects / Q000382:microbiology*; D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D007223:Infant; D008297:Male; D010530:Peritoneal Dialysis / Q000295:instrumentation*; D010538:Peritonitis / Q000382:microbiology; D016459:Prosthesis-Related Infections / Q000382:microbiology / Q000601:surgery*; D012086:Reoperation; D012189:Retrospective Studies; D016896:Treatment Outcome