Merit of the cuff-shaving procedure in children with chronic infection

Pediatr Nephrol. 2004 Nov;19(11):1267-72. doi: 10.1007/s00467-004-1621-y.

Abstract

Catheter replacement and cuff-shaving are per-formed as a surgical treatment against tunnel infection(TI) in patients on chronic peritoneal dialysis. The efficacy of catheter replacement is well established, but that of cuff-shaving is not. For the purpose of evaluating the efficacy of cuff-shaving, we compared the time interval between each procedure and subsequent TI. In order to perform this comparison, we reviewed data from 32 cuff-shaving procedures and 29 catheter replacement procedures at Tokyo Metropolitan Kiyose Children's Hospital in the period from 1 March 1991 to 1 May 2001, retrospectively. There was no significant difference in the time interval between each procedure and subsequent TI(P=0.284). The incidence of recurrence was no more than 12.5% for the cuff-shaving procedures. The incidence of peritonitis due to post-surgery TI with the cuff-shaving procedures was 9.3% and 6.8% with the replacement procedure (P=0.725). There was no significant variation in time interval to post-cuff-shaving TI according to the reason for the cuff-shaving procedure. In conclusion,cuff-shaving may be worth considering for TI in adequately selected patients.

Publication types

  • Comparative Study

MeSH terms

  • Adolescent
  • Catheterization / adverse effects*
  • Catheterization / instrumentation
  • Catheters, Indwelling / adverse effects
  • Catheters, Indwelling / microbiology*
  • Child
  • Child, Preschool
  • Female
  • Humans
  • Infant
  • Male
  • Peritoneal Dialysis / instrumentation*
  • Peritonitis / microbiology
  • Prosthesis-Related Infections / microbiology
  • Prosthesis-Related Infections / surgery*
  • Reoperation
  • Retrospective Studies
  • Treatment Outcome