Dialysis 0003 Application of a Physical Antimicrobial Spray Dressing for Reducing Postoperative Peritoneal Dialysis Catheter Exit Site Infection in End-stage Renal Failure Patients : A Prospective Cohort Study

Objective: Exit site infection (ESI) in the early stage of peritoneal dialysis (PD) catheter insertion period which will disrupt healthy sinus tract formation and may lead to peritonitis and catheter removal. None of the current strategies is considered a successful measure in preventing early ESI. The aim of this study was to evaluate the effectiveness of JUC non-pharmacological, nano-technology physical antimicrobial spray dressing (JUC ) on postoperative PD exit site care with respect to reduction of infection risk and patient comfort. Methods: A prospective study was conducted from December 2012 to July 2014 and the results compared with a historical cohort data obtained between 2010 to 2011 in the same Renal unit (see table). JUC was administered to exit sites of consenting subjects. The incidence rate of ESI, the causative microorganisms and demographic data were compared between the study and the retrospective control group. Pain was assessed by a numeric pain score. An exit site swab culture was performed two weeks after PD catheter insertion to determine presence of colonizing organisms. The patients were observed for ESI for 4 weeks. Results:Of the 95 subjects completing the study, eight developed PD catheter ESI. ESI incidence (within 4 weeks after PD catheter insertion) in the study groupwas only 8.4%comparedwith 19% in thecontrol group, representing a significant decrease in ESI by 56% (PZ 0.038, Chi-squared test). The causativemicroorganisms for ESI in the study group were coagulase-negative Staphylococci (12.5%), Corynebacterium species (12.5%), Staphylococcus aureus (62.5%) and Pseudomonas aeruginosa (12.5%). For the numeric pain score (0 to 10), 93% of the subjects reported from 0 to 2. There were no adverse effects, skin discomfort nor delayed sinus epithelialization for wound healing reported. Conclusion: JUC physical non-pharmacological nano-technology antimicrobial spray dressing is effective and safe in preventing early postoperative PD catheter ESI.