Negative-pressure wound therapy is effective for peritoneal dialysis catheter exit-site management in the early postoperative period

Sci Rep. 2022 Jan 7;12(1):70. doi: 10.1038/s41598-021-03878-5.

Abstract

Peritoneal dialysis (PD) catheter exit-site care is critically important for the prevention of catheter-related infections (CRIs) and subsequent peritonitis. The postoperative management of the site is particularly essential because it has an open wound that is always adjacent to a PD catheter tube. This study aimed to examine the effectiveness of negative-pressure wound therapy (NPWT) for postoperative PD catheter exit sites. Thirty patients with end-stage renal disease who underwent simultaneous PD catheter insertion and exit-site formation were randomly assigned to receive NPWT (NPWT group) or conventional dressing (non-NPWT group) for the first seven postoperative days. The exit-site scores on the seventh postoperative day was lower in the NPWT group than in the non-NPWT group (p = 0.0049). Analysis of variance F statistic for the effect of NPWT over 180 days was highly significant (11.482595, p = 0.007). There were no statistically significant differences between the time to first CRI and PD-related peritonitis between the two groups. There was one case of CRI with relapsing peritonitis and catheter loss in the non-NPWT group. These findings demonstrate the association between NPWT and low exit-site score. NPWT can be recommended for the management of PD catheter exit sites in the early postoperative period.

Publication types

  • Randomized Controlled Trial
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Catheter-Related Infections / etiology
  • Catheter-Related Infections / prevention & control*
  • Catheters, Indwelling*
  • Female
  • Humans
  • Kidney Failure, Chronic / diagnosis
  • Kidney Failure, Chronic / therapy*
  • Male
  • Middle Aged
  • Negative-Pressure Wound Therapy*
  • Peritoneal Dialysis / adverse effects
  • Peritoneal Dialysis / instrumentation*
  • Peritonitis / etiology
  • Peritonitis / prevention & control*
  • Time Factors
  • Tokyo
  • Treatment Outcome