St Laurent M, Surendranath C, Saad T, Halff G, Esterl R
Department of Surgery, University of Texas Health Science Center at San Antonio 78284-7842, USA.
Am Surg. 1998 Dec;64(12):1215-7.
The management of catheter-related infections has become a major challenge in continuous ambulatory peritoneal dialysis treatment. We identified five patients on continuous ambulatory peritoneal dialysis who failed conservative medical management for exit site infections. Each patient underwent incision and debridement along the subcutaneous course of the catheter, exteriorization of the superficial cuff, and establishment of a new exit site at the medial aspect of the wound. This novel technique of incision and debridement along the subcutaneous tunnel and relocation of the exit site has not been described in the literature. In four of five patients, this technique controlled the exit site infection and arrested the progression of the infection to peritonitis, preventing the need for catheter removal.
在持续性非卧床腹膜透析治疗中，导管相关感染的管理已成为一项重大挑战。我们确定了5例接受持续性非卧床腹膜透析的患者，他们因出口处感染而未能通过保守药物治疗成功治愈。每位患者均沿着导管的皮下走行进行切开和清创，将浅表袖套外置，并在伤口内侧建立新的出口处。这种沿着皮下隧道进行切开和清创以及重新定位出口处的新技术在文献中尚未有描述。在5例患者中的4例中，该技术控制了出口处感染，并阻止了感染向腹膜炎进展，从而避免了拔除导管的必要性。
