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Hypertonic saline compresses: therapy for complicated exit-site infections
F G Strauss1, D L Holmes, D F Nortman
1Los Angeles Dialysis Training Center, California.
Summary
Hypertonic saline compress therapy effectively resolved complicated peritoneal dialysis catheter exit-site infections in all patients. This safe, inexpensive treatment offers a promising alternative for managing these challenging infections.
Area of Science:
- Nephrology
- Infectious Diseases
- Dermatology
Background:
- Complicated exit-site infections (ESIs) in peritoneal dialysis (PD) patients pose a significant treatment challenge.
- Conventional therapies, including local measures and systemic antibiotics, often fail or are poorly tolerated.
Purpose of the Study:
- To evaluate the efficacy and safety of hypertonic saline compress therapy for complicated PD catheter ESIs.
Main Methods:
- A retrospective review of 17 patients with complicated ESIs treated with warm 3% saline compresses (3 times daily for 2-4 weeks, then daily).
- Analysis of treatment outcomes, including resolution rates, recurrence, and adverse effects.
- Comparison with conventional treatments in patients with culture-positive and culture-negative infections.
Main Results:
- Hypertonic saline compress therapy achieved complete resolution of ESIs in all 17 patients without recurrence during a mean follow-up of 6.5 months.
- Conventional therapies failed in 8 patients with culture-positive ESIs and local therapy alone was insufficient for 3 antibiotic-intolerant patients.
- Culture-negative ESIs also resolved with hypertonic saline compress therapy.
Conclusions:
- Hypertonic saline compress therapy is a highly effective, safe, well-accepted, and cost-effective treatment for complicated PD catheter exit-site infections.
- This therapy presents a valuable alternative, particularly for patients with treatment-resistant or antibiotic-intolerant infections.
- Potential for prophylactic use and combination therapy warrants further investigation.