Nursing interventions related to peritoneal catheter exit-site infections

Nursing interventions related to peritoneal catheter exit-site infection include an emphasis on prevention and early diagnosis as well as exit-site care. The key elements to prevention of exit-site infections are avoiding trauma to the exit-site and tunnel, avoiding gross contamination of the exit-site, and cleaning a wet or dirty exit-site as soon as possible. Early diagnosis of exit-site infection is promoted by (1) teaching the patient or caregiver to assess the exit-site and tunnel routinely and to promptly recognize and report signs and symptoms of inflammation, and (2) routine exit-site evaluation by health care providers in the outpatient clinic. Care of the infected exit-site should focus on preventing cross contamination, keeping the exit-site dry, avoiding trauma and irritation, and in addition to routine care, may require removal of stubborn crusts and cauterization of proud flesh. Topical soaks and therapy have been recommended, but improvement of infected exit-sites has not been consistently documented.