Tunnel and peritoneal catheter exit site infections in continuous ambulatory peritoneal dialysis (CAPD)
What is an exit site infection?
Normal bacteria live on the skin and can sometimes invade damaged tissue, causing an infection on the exit site.
Exit site infections are usually visible. The skin around the exit site will be red and inflamed, and crusts with pus are generally present. There may be some pain and tenderness. If untreated, exit site infections can get worse, possibly leading to peritonitis or requiring removal of the PD catheter. Not all irritated exit sites are infected, and it may be difficult for you to tell if an infection exists. An immediate examination by the PD nurse is recommended if there’s a possibility of an exit site infection.
Mild infections may require more careful PD catheter restraints and local treatment with topical antibiotics, special cleansing solutions and/or hypertonic saline. Severe infections require antibiotics for 2-6 weeks. In cases that don’t improve, intravenous antibiotics or catheter removal may be necessary.
Avoiding injury to the exit site and using daily antibiotic cream are the main means of preventing this problem. Most exit site infections heal completely when appropriate treatment is given in a timely fashion, but the real key to success is to avoid them in the first place.
Exit site infections are usually visible. The skin around the exit site will be red and inflamed, and crusts with pus are generally present. There may be some pain and tenderness. If untreated, exit site infections can get worse, possibly leading to peritonitis or requiring removal of the PD catheter. Not all irritated exit sites are infected, and it may be difficult for you to tell if an infection exists. An immediate examination by the PD nurse is recommended if there’s a possibility of an exit site infection.
Mild infections may require more careful PD catheter restraints and local treatment with topical antibiotics, special cleansing solutions and/or hypertonic saline. Severe infections require antibiotics for 2-6 weeks. In cases that don’t improve, intravenous antibiotics or catheter removal may be necessary.
Avoiding injury to the exit site and using daily antibiotic cream are the main means of preventing this problem. Most exit site infections heal completely when appropriate treatment is given in a timely fashion, but the real key to success is to avoid them in the first place.