Journal Watch - Infections
Simultaneous Hernia Repair and PD Catheter Placement
Taking care of two surgeries at once saves a procedure, recovery time, and costs. Among 123 patients who had catheters placed at a single center over a 4-year period, 23 (19%) had hernias. Across the 23, 27 procedures were done combining hernia repair with PD catheter placement. None of the hernias recurred, and there were no early surgical site infections. Five of the patients developed new hernias at other sites, but after a median of about 3 years, 96% of the catheters were still working.
Read the abstract » | (added 12/10/2019)
A Post-op Surgical Girdle for Pain and Catheter Tunnel Infections in Urgent Start PD
Urgent start PD can be associated with pain and tunnel infections. In a study of 85 consecutive PD catheter placements, a surgical girdle was used from days 1-3 while patients were supine. Among the 23 patients who completed pain surveys, the girdle helped significantly. Tunnel infections were reduced as well.
Read the abstract » | (added 11/16/2019)
PD and Swimming
Australian nurses in 39 PD clinics conducted phone surveys. While only 77% of the clinics advocated swimming, nearly all had patients who did swim, mainly in sea water or a private pool. Covering the exit site and catheter with a waterproof dressing or ostomy bag was recommended, along with routine exit-site care. Several infections were linked with swimming.
Read the abstract » | (added 10/14/2019)
Moving the PD Exit Site to Combat Infection
A 5-year retrospective cohort analysis looked at the impact of treating PD exit site and tunnel infections in 27 patients by removing the cuff and relocating the catheter under local anesthetic. After follow up ranging from 10.8 to 79.4 months, no leaks occurred, and the infections resolved in 74% of the patients. The rest had to have their catheters removed.
Read the abstract » | (added 06/13/2019)
Which PD Exit Site Dressing is Better?
Is an occlusive dressing better to reduce exit site or tunnel infections? A semi-occlusive one? It made no difference, found a new analysis of 2,460 incident PD patients. Read the abstract.
Read the abstract » | (added 11/13/2017)
Striking Lack of Data on Infection Prevention in PD
A Cochrane database review of 59 randomized controlled studies revealed “striking” gaps in our knowledge about what really works to prevent infections in PD. Oral or topical antibiotics and topical disinfectants had uncertain benefits for exit site, tunnel infections, or peritonitis. Use of IV vancomycin prior to catheter placement may reduce the risk of early peritonitis. Antifungal treatments may reduce fungal peritonitis after antibiotics.
Read the abstract » | (added 04/12/2017)
Tags: Peritoneal Dialysis
Urgent Start PD vs. HD
Which option is better if someone “crashes” into dialysis? A retrospective study was done of 178 people who started dialysis urgently between January, 2013 and December, 2014. Those who started PD had far fewer complications in the first 30 days. HD patients had more bloodstream infections. Survival was about the same for both groups.
Read the abstract » | (added 12/09/2016)
Upper Abdominal PD Exit Site May Reduce Infection
A change in the exit site location may matter for PD. A non-randomized study of 147 catheter placements compared standard straight catheters to longer, swan-neck ones placed in the upper abdomen. Those with the upper abdominal catheters had far less exit site and tunnel infections. Peritonitis rates were similar.
Read the abstract » | (added 02/09/2016)
Gentamycin Ointment For PD Exit Sites Did Not Increase Antibiotic Resistance
A review compared 10 years PD exit-site care using oral rifampin and mupirocin ointment (n=265) with 10 years of gentamycin cream (n=179). While the demographics were largely similar apart from race, there were significantly fewer gram-negative exit site infections using gentamycin, with very low rates of gentamycin resistant infections in either period.
Read the abstract » | (added 12/10/2015)
Vascular Access Technique Audits Can Reduce Home HD Access Infections
Self-cannulation errors can lead to infections. A retrospective study of all prevalent home HD patients at the University Health Network in Canada looked at access infections between 2006 and 2013. Among the 92 patients who completed at least one vascular access audit, those with five or more errors had significantly higher infection rates. Longer duration on home HD was associated with higher error rates. Audits give nurses a chance to retrain patients and reduce future errors and infections.
Read the abstract » | (added 11/11/2015)