Recommendations for exit site care of peritoneal catheter in light of recent publications

Abstract

Exit site infections are one of the most frequent infective complications of peritoneal dialysis. These infections may increase risk of peritonitis and be the reason for catheter removal and technique failure. This paper reviews the most important elements of optimal exit site care. These are: appropriate implantation technique of peritoneal catheter, institution of antibiotic prophylaxis, optimal technique of change of dressing aiming at preventing contamination, ongoing assessment of the exit site and tunnel with early identification and treatment of exit-site problems, immobilization of the catheter to protect from trauma and effective education and reeducation. Benefits and drawbacks of topical antibiotics are reviewed as well as recent studies with use of honey and other antiseptics in care of peritoneal catheter exit site.