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Abstract
Introduction: The care of the peritoneal catheter exit site is vital because it affects the success and future of peritoneal dialysis.
General Objetive: To analyse infectious complications in peritoneal dialysis according to the antiseptic used to cure the exit site.
Material and Method: Descriptive observational study with retrospective data collection, with a duration of 90 months, from January 2015 to June 2022, in a population of peritoneal dialysis patients. An analysis was made of peritoneal catheter exit site infections and possible complications in the two periods, according to the antiseptic used, from January 2015 to December 2018 and January 2019 to December 2022. The variables collected were the antiseptic used in the two periods described (povidone-iodine and chlorhexidine soap), the rate of orifice infections, and the rate of infectious complications.
Results: Fifty patients were studied. Regarding exit wound infection, a reduction was observed in the chlorhexidine soap group (p=0.02). The rate of peritonitis was higher in the povidone group, although the results were not statistically significant.
Conclusions: Chlorhexidine soap showed a decrease in orifice infections and infectious complications.
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Copyright (c) 2024 Cristina Vazquez Ros
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References
- NEW: Infection prevention and control in dialysis settings (2022) [Internet]. APIC. 2022 [consultado 4 May 2023]. Disponible en: https://apic.org/implementation_guide/infection-prevention-and-control-in-dialysis-settings/.
- Gándara Revuelta M, Begines Ramírez A, Sola García MT, Alonso Nates R, Cobo Sánchez JL, Higuera Roldan C, et al. Repercussion of a care protocol on the prevalence of cather exit wound infection in peritoneal dialysis. Rev Soc Esp Enferm Nefrol [Internet]. 2011 [consultado 7 Mar 2023];14(4):271-4. Disponible en: https://scielo.isciii.es/scielo.phpscript=sci_arttext&pid=S1139-13752011000400010&lng=en&nrm=iso&tlng=en
- Gil Gil A, Gisbert Rosique E, Castillo Díaz M, Baró Salvador ME. Efectividad clínica en el cuidado del orificio de salida del catéter peritoneal. Enferm Nefrol. 2012;15(3):194-201.
- Gómez Castilla A. Concepción, Martín Espejo J. Lucas, Trujillo Campos Carmen, Laguillo de Castro Ángela, Tejuca Marenco Mercedes, López Bermúdez Encarnación et al. Comportamiento del orificio de implantación del catéter en pacientes en diálisis peritoneal en relación a los cuidados. Rev Soc Esp Enferm Nefrol [Internet]. 2007 Dic [consultado 7 Mar 2023];10(4):7-13. Disponible en: http://scielo.isciii.es/scielo.php?script=sci_arttext&pid=S1139-13752007000400002&lng=es
- Luzar MA. Exit-site infection in continuous ambulatory peritoneal dialysis: a review. Perit Dial Int [Internet]. 1991 [consultado 7 Mar 2023];11(4):333-40. Disponible en: https://pubmed.ncbi.nlm.nih.gov/1751600/.
- PROCEDIMIENTOS Y PROTOCOLOS CON COMPETENCIAS ESPECÍFICAS PAR [Internet]. Seden.org. [consultado 7 Mar 2023]. Disponible en: https://formacion.seden.org/aulamedica/procedimientos-seden/files/assets/basic-html
- Luzar MA, Brown CB, Balf D, Hill L, Issad B, Monnier B, et al. Exit-site care and exit-site infection in continuous ambulatory peritoneal dialysis (CAPD): results of a randomized multicenter trial. Perit Dial Int [Internet]. 1990 [consultado 7 Mar 2023];10(1):25-9. Disponible en: https://pubmed.ncbi.nlm.nih.gov/2085577/.
- Htay H, Choo JCJ, Johnson DW, Pascoe EM, Jayaballa M, Oei EL, et al. Chlorhexidine-impregnated sponge dressing for prevention of catheter exit-site infection in peritoneal dialysis patients: a pilot study. Int Urol Nephrol [Internet]. 2021 [consultado 7 Mar 2023];53(4):803-12. Disponible en: https://pubmed.ncbi.nlm.nih.gov/33025409/.
- Olga B, Fotis Z, Margarita I, Sofia X, Konstantinos S. Chlorhexidine for routine PD catheter exit-site care. Int Urol Nephrol [Internet]. 2016 [consultado 7 Mar 2023];48(9):1543-6. Disponible en: https://pubmed.ncbi.nlm.nih.gov/27432412/.
- Hain DJ, Chan J. Best available evidence for peritoneal dialysis catheter exit-site care. Nephrol Nurs J [Internet]. 2013 [consultado 7 Mar 2023];40(1):63-9. Disponible en: https://pubmed.ncbi.nlm.nih.gov/23539808/.
- Shelton DM. A comparison of the effects of two antiseptic agents on Staphylococcus epidermidis colony forming units at the peritoneal dialysis catheter exit site. Adv Perit Dial [Internet]. 1991 [consultado 7 Mar 2023];7:120-4. Disponible en: https://pubmed.ncbi.nlm.nih.gov/1680406/.
- Lockwood C, Hodgkinson B, Page T. Clinical effectiveness of different approaches to peritoneal dialysis catheter exit-site care. JBI Libr Syst Rev [Internet]. 2003 [consultado 7 Mar 2023];1(5):1-52. Disponible en: https://pubmed.ncbi.nlm.nih.gov/27820413/.
- Kopriva-Altfahrt G, König P, Mündle M, Prischl F, Roob JM, Wiesholzer M, et al. Exit-site care in Austrian peritoneal dialysis centers -- a nationwide survey. Perit Dial Int [Internet]. 2009 [consultado 7 Mar 2023];29(3):330-9. Disponible en: https://pubmed.ncbi.nlm.nih.gov/19458307/.
- J Montenegro. Prevención y tratamiento de la infección del orificio de salida de catéter peritoneal. Nefrologia [Internet]. 1999 [consultado 7 Mar 2023];19(6):502–7. Disponible en: https://www.revistanefrologia.com/es-prevencion
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References
NEW: Infection prevention and control in dialysis settings (2022) [Internet]. APIC. 2022 [consultado 4 May 2023]. Disponible en: https://apic.org/implementation_guide/infection-prevention-and-control-in-dialysis-settings/.
Gándara Revuelta M, Begines Ramírez A, Sola García MT, Alonso Nates R, Cobo Sánchez JL, Higuera Roldan C, et al. Repercussion of a care protocol on the prevalence of cather exit wound infection in peritoneal dialysis. Rev Soc Esp Enferm Nefrol [Internet]. 2011 [consultado 7 Mar 2023];14(4):271-4. Disponible en: https://scielo.isciii.es/scielo.phpscript=sci_arttext&pid=S1139-13752011000400010&lng=en&nrm=iso&tlng=en
Gil Gil A, Gisbert Rosique E, Castillo Díaz M, Baró Salvador ME. Efectividad clínica en el cuidado del orificio de salida del catéter peritoneal. Enferm Nefrol. 2012;15(3):194-201.
Gómez Castilla A. Concepción, Martín Espejo J. Lucas, Trujillo Campos Carmen, Laguillo de Castro Ángela, Tejuca Marenco Mercedes, López Bermúdez Encarnación et al. Comportamiento del orificio de implantación del catéter en pacientes en diálisis peritoneal en relación a los cuidados. Rev Soc Esp Enferm Nefrol [Internet]. 2007 Dic [consultado 7 Mar 2023];10(4):7-13. Disponible en: http://scielo.isciii.es/scielo.php?script=sci_arttext&pid=S1139-13752007000400002&lng=es
Luzar MA. Exit-site infection in continuous ambulatory peritoneal dialysis: a review. Perit Dial Int [Internet]. 1991 [consultado 7 Mar 2023];11(4):333-40. Disponible en: https://pubmed.ncbi.nlm.nih.gov/1751600/.
PROCEDIMIENTOS Y PROTOCOLOS CON COMPETENCIAS ESPECÍFICAS PAR [Internet]. Seden.org. [consultado 7 Mar 2023]. Disponible en: https://formacion.seden.org/aulamedica/procedimientos-seden/files/assets/basic-html
Luzar MA, Brown CB, Balf D, Hill L, Issad B, Monnier B, et al. Exit-site care and exit-site infection in continuous ambulatory peritoneal dialysis (CAPD): results of a randomized multicenter trial. Perit Dial Int [Internet]. 1990 [consultado 7 Mar 2023];10(1):25-9. Disponible en: https://pubmed.ncbi.nlm.nih.gov/2085577/.
Htay H, Choo JCJ, Johnson DW, Pascoe EM, Jayaballa M, Oei EL, et al. Chlorhexidine-impregnated sponge dressing for prevention of catheter exit-site infection in peritoneal dialysis patients: a pilot study. Int Urol Nephrol [Internet]. 2021 [consultado 7 Mar 2023];53(4):803-12. Disponible en: https://pubmed.ncbi.nlm.nih.gov/33025409/.
Olga B, Fotis Z, Margarita I, Sofia X, Konstantinos S. Chlorhexidine for routine PD catheter exit-site care. Int Urol Nephrol [Internet]. 2016 [consultado 7 Mar 2023];48(9):1543-6. Disponible en: https://pubmed.ncbi.nlm.nih.gov/27432412/.
Hain DJ, Chan J. Best available evidence for peritoneal dialysis catheter exit-site care. Nephrol Nurs J [Internet]. 2013 [consultado 7 Mar 2023];40(1):63-9. Disponible en: https://pubmed.ncbi.nlm.nih.gov/23539808/.
Shelton DM. A comparison of the effects of two antiseptic agents on Staphylococcus epidermidis colony forming units at the peritoneal dialysis catheter exit site. Adv Perit Dial [Internet]. 1991 [consultado 7 Mar 2023];7:120-4. Disponible en: https://pubmed.ncbi.nlm.nih.gov/1680406/.
Lockwood C, Hodgkinson B, Page T. Clinical effectiveness of different approaches to peritoneal dialysis catheter exit-site care. JBI Libr Syst Rev [Internet]. 2003 [consultado 7 Mar 2023];1(5):1-52. Disponible en: https://pubmed.ncbi.nlm.nih.gov/27820413/.
Kopriva-Altfahrt G, König P, Mündle M, Prischl F, Roob JM, Wiesholzer M, et al. Exit-site care in Austrian peritoneal dialysis centers -- a nationwide survey. Perit Dial Int [Internet]. 2009 [consultado 7 Mar 2023];29(3):330-9. Disponible en: https://pubmed.ncbi.nlm.nih.gov/19458307/.
J Montenegro. Prevención y tratamiento de la infección del orificio de salida de catéter peritoneal. Nefrologia [Internet]. 1999 [consultado 7 Mar 2023];19(6):502–7. Disponible en: https://www.revistanefrologia.com/es-prevencion
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