Surgical salvage of peritoneal dialysis catheters from chronic exit-site and tunnel infections.
BACKGROUND
Chronic exit-site and tunnel infections of the peritoneal dialysis catheter are significant causes of catheter loss. Surgical salvage procedures that can effectively resolve the infection and preserve dialysis are of major importance.


METHODS
Thirteen patients with chronic exit-site and tunnel infections underwent surgical salvage consisting of unroofing the tunnel tract and shaving of the superficial catheter cuff. A control group of 138 patients implanted during the same time span as the study group was used for infection rate and survival comparisons.


RESULTS
The salvage procedure cured the infection in all patients. No dialysate leaks occurred. Peritoneal dialysis was not interrupted. Surgical salvage provided successful long-term peritoneal dialysis that was equivalent to the cohort dialysis population.


CONCLUSIONS
Surgical salvage by unroofing/cuff shaving is an effective long-term solution for chronic exit-site and tunnel infection.
Crabtree
John H
JH
Department of Surgery, Southern California Permanente Medical Group, Kaiser Permanente Bellflower Medical Center, Bellflower, CA 90706, USA. John.H.Crabtree@kp.org
Burchette
Raoul J
RJ
D016022:Case-Control Studies; D002404:Catheterization / Q000009:adverse effects*; D002408:Catheters, Indwelling / Q000009:adverse effects* / Q000382:microbiology; D003646:Debridement / Q000379:methods; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008134:Long-Term Care; D008297:Male; D010530:Peritoneal Dialysis / Q000009:adverse effects / Q000295:instrumentation; D016012:Poisson Distribution; D011336:Probability; D012016:Reference Values; D012189:Retrospective Studies; D018570:Risk Assessment; D016879:Salvage Therapy; D013203:Staphylococcal Infections / Q000209:etiology / Q000601:surgery; D013530:Surgical Wound Infection / Q000382:microbiology / Q000601:surgery*; D016896:Treatment Outcome; D014945:Wound Healing / Q000502:physiology