The Moncrief-Popovich catheter. A new peritoneal access technique for patients on peritoneal dialysis

Area of Science:

• Medical Engineering
• Infectious Disease Prevention
• Surgical Innovation

Background:

• Current catheter implantation methods compromise wound healing by creating direct pathways for bacterial colonization.
• Biofilm formation on implanted catheters is a near-universal complication, leading to infections like peritonitis.
• The Moncrief-Popovich catheter and implantation technique were developed to mitigate these issues.

Purpose of the Study:

• To evaluate the efficacy of the Moncrief-Popovich catheter and implantation technique in reducing peritonitis and exit site infections.
• To assess the impact of burying the external catheter segment on infection rates.
• To compare infection rates with standard catheter implantation methods.

Main Methods:

• A prospective trial involving 59 patients and 530 patient-months of experience was conducted.
• The Moncrief-Popovich catheter was implanted with its external segment buried subcutaneously for 3-5 weeks before exteriorization.
• Peritonitis and exit site infection rates were tracked using both standard spike exchange and disconnect procedures.

Main Results:

• The incidence of peritonitis was one episode per 29.4 patient-months with the standard spike exchange technique.
• In a subset using disconnect procedures, the peritonitis rate was one episode per 28.7 patient-months.
• The rate of exit site infections was one episode per 12.57 patient-months.

Conclusions:

• The Moncrief-Popovich catheter and implantation technique significantly decrease the incidence of peritonitis in patients using the standard spike exchange system.
• This technique offers a promising solution for reducing catheter-related infections.
• The findings support the adoption of this modified implantation strategy to improve patient safety.