Surgical salvage of peritoneal dialysis catheters from chronic exit-site and tunnel infections.

BACKGROUND

Chronic exit-site and tunnel infections of the peritoneal dialysis catheter are significant causes of catheter loss. Surgical salvage procedures that can effectively resolve the infection and preserve dialysis are of major importance.

METHODS

Thirteen patients with chronic exit-site and tunnel infections underwent surgical salvage consisting of unroofing the tunnel tract and shaving of the superficial catheter cuff. A control group of 138 patients implanted during the same time span as the study group was used for infection rate and survival comparisons.

RESULTS

The salvage procedure cured the infection in all patients. No dialysate leaks occurred. Peritoneal dialysis was not interrupted. Surgical salvage provided successful long-term peritoneal dialysis that was equivalent to the cohort dialysis population.

CONCLUSION

Surgical salvage by unroofing/cuff shaving is an effective long-term solution for chronic exit-site and tunnel infection.