Keeping the catheter exit site clean by sealing with a dressing film in patients under continuous ambulatory...

In patients on continuous ambulatory peritoneal dialysis (CAPD), exit-site care is troublesome. We developed a new method for exit-site care, using a dressing film. We investigated the possibility of keeping the exit site clean for up to 6 weeks, using seven protocols: Control group (n = 24)--the exit site was cleaned with a povidone iodine solution daily and a gauze dressing was applied. Group A (n = 120)--the exit site was cleaned with a povidone iodine solution once weekly, was covered with a small piece of gauze, and was completely sealed using a dressing film. Group B (n = 181)--as with Group A, except once every 2 weeks. Group C (n = 64)--as with Group A, except once every 3 weeks. And so on: Group D (n = 45)--once every 4 weeks. Group E (n = 8)--once every 5 weeks. Group F (n = 2)--once every 6 weeks. At each session, we examined the small gauze bacteriologically. In groups A-F, the patients were asked to bathe every day and not to do anything about the exit site for 1-6 weeks, as applicable. In the control group, the rate of positive bacterial culture was 87.5%. In the other groups, the rates were group A, 15%; group B, 6.6%; group C, 6.3%; group D, 2.2%; and groups E and F, 0%. In the film-method groups, the rates of positive bacterial culture were significantly low. We thought that the film method kept the exit site clean.