Amano I, Katoh T, Inagaki Y
Department of Dialysis Therapy, Chukyo Hospital, Nagoya, Japan.
ASAIO Trans. 1990 Jul-Sep;36(3):M494-6.
It is very important to prevent skin exit site infections in order to continue continuous ambulatory peritoneal dialysis (CAPD) safely over the long-term. The silicon material conventionally used can result in sinus formation between the skin and the catheter, and may trigger exit site infections. To resolve this problem, we employed a bioinert, rigid, and nonporous transcutaneous connector made of alumina ceramic. Earlier long-term animal experiments with alumina ceramic placed in soft tissue demonstrated the outstanding biocompatibility of this material. The transcutaneous connector was designed with a simple cylindrical configuration; in order to make sufficient contact between this connector and the patient, a silicon tube was made into a swan neck catheter with a disk-shaped Dacron cuff at the upper position in order to reinforce adhesion to soft tissue. Ten CAPD patients (maximum time on dialysis of 14 months) have used the new CAPD catheter system with no exit site infections to date. Furthermore, there has been virtually no downgrowth of the skin around the connector, while the connector and tissue have remained in very close contact.
为了长期安全地继续进行持续性非卧床腹膜透析（CAPD），预防皮肤出口处感染非常重要。传统使用的硅材料会导致皮肤与导管之间形成窦道，并可能引发出口处感染。为了解决这个问题，我们采用了一种由氧化铝陶瓷制成的生物惰性、刚性且无孔的经皮连接器。早期将氧化铝陶瓷置于软组织中的长期动物实验证明了这种材料具有出色的生物相容性。经皮连接器设计为简单的圆柱形结构；为了使该连接器与患者充分接触，将硅管制成带有盘状涤纶套囊的鹅颈导管，套囊位于上方位置以增强对软组织的粘附力。十名CAPD患者（透析最长时间为14个月）使用了新的CAPD导管系统，迄今为止未发生出口处感染。此外，连接器周围的皮肤几乎没有向下生长，而连接器与组织一直保持非常紧密的接触。
