GuidelinesOther guideline
Prevention and Treatment of Exit Site Infections
The exit site should be kept clean, dry, scab-free, crustfree, painless, and noninflamed Immobilization of the catheter and protection from trauma is essential The exit site should be cleaned every other day using aseptic technique Aqueous chlorhexidine 0.05% should be used until the site is clean and the chlorhexidine is then removed with water The exit site should be swabbed and cultured once a
- The exit site should be kept clean, dry, scab-free, crustfree, painless, and noninflamed
- Immobilization of the catheter and protection from trauma is essential
- The exit site should be cleaned every other day using aseptic technique
- Aqueous chlorhexidine 0.05% should be used until the site is clean and the chlorhexidine is then removed with water
- The exit site should be swabbed and cultured once a month or when there are signs of infection
- Positive Staph cultures but no clinical signs of infection should be treated with topical mupirocin ointment for 4 weeks
- If the tunnel looks infected, treat with topical mupirocin ointment, oral flucloxacillin and oral nystatin. Treatment is adapted when culture and sensitivity data are available. If no positive culture, continue with above treatment for a minimum of 4 weeks
- If no improvement by 4 weeks consider replacement of the catheter.
Touch contamination
Advise patient to:
- Replace minicap
- Twist clamp on transfer set to closed position
- Report to hospital
When patient reports to hospital:
- Drain peritoneal fluid and send for culture
- Change transfer set
- Add vancomycin 10 mg or Kefzol 25 mg to a 1 litre twin bag of dialysate
- Instill the usual fill volume of the patient and leave in the peritoneal cavity for at least 3 hours, then drain.
Van Biljon I, Bhimma R, Gajjar P, McCulloch M, Nourse P. Guideline for Chronic Dialysis in Children in South Africa. South African Renal Society; 2015.