Cuff-shaving procedure. A rescue treatment for exit-site infection unresponsive to medical therapy

Nephrol Dial Transplant. 1995 Dec;10(12):2325-7. doi: 10.1093/ndt/10.12.2325.

Abstract

We performed 41 cuff-shaving procedures in 38 patients on continuous ambulatory peritoneal dialysis (CAPD) with exit-site infection unresponsive to medical treatment. Cuff shaving was performed on three patients with two catheters each. This procedure was effective in eliminating 50% of S. aureus exit-site infection and all S. epidermidis exit-site infection, but was ineffective in Gram-negative exit-site infection. After cuff-shaving procedure, 20 catheters (49%) were removed; 11 for persistent tunnel infection and nine because of development of secondary peritonitis. The probability of catheter survival at 1 year was 50% and remained stable thereafter. Cuff-shaving procedure may be a valuable mode of therapy for treating patients with S. aureus and/or S. epidermidis exit-site infection unresponsive to medical treatment.

MeSH terms

  • Anti-Bacterial Agents / therapeutic use
  • Catheters, Indwelling / adverse effects*
  • Catheters, Indwelling / microbiology
  • Female
  • Gram-Negative Bacteria / isolation & purification
  • Humans
  • Kidney Failure, Chronic / complications
  • Kidney Failure, Chronic / therapy*
  • Male
  • Middle Aged
  • Peritoneal Dialysis, Continuous Ambulatory
  • Peritonitis / microbiology*
  • Peritonitis / therapy
  • Staphylococcus / isolation & purification

Substances

  • Anti-Bacterial Agents