Peritoneal Dialysis Access Technology: The Austin Diagnostic Clinic Experience

Moncrief, Jack W.; Popovich, Robert P.; Seare, W. J.; Sorrels, Poppy A.J.; Moncrief, D. Barrett; Settle, Stephen M.; Simmons, E.

doi:10.1177/089686089601601s62

Cited by 15 publications

(10 citation statements)

References 3 publications

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“…Moncrief et al (16) devised a placement technique in which the entire peritoneal catheter can be buried under the skin some weeks to months before it is used. The catheter burying technique was first described for placement of a modified Tenckhoff catheter with a 2.5 cm long superficial cuff, but the technique has been adopted for standard dual‐cuff Tenckhoff catheters (17–19). In the original technique the external portion of the catheter was brought through a 2–3 cm skin exit site (much larger than the usual 0.5 cm incision).…”

Section: Burying the Pd Cathetermentioning

confidence: 99%

Interventional Nephrology and Dialysis: Chronic Peritoneal Dialysis Catheters: Overview of Design, Placement, and Removal Procedures

Ash

2003

Seminars in Dialysis

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The success of chronic peritoneal dialysis (PD) depends to a large extent on the success of the chronic PD access device. For the nephrologist placing and removing PD catheters, or for the nephrologist advising surgeons in this role, this article provides a review of designs of PD catheters and differences in function and complications, methods of insertion of PD catheters and relation to catheter outcomes, techniques for "burying" the external portion of the PD catheter and benefits of this technique, and techniques for removing PD catheters. As nephrologists become more closely involved in the creation, monitoring, and maintenance of access devices for end-stage renal disease (ESRD) patients, the successful function of these devices will increase. Nephrologists should make the critical decisions regarding the choice of access devices and methods for placement as they do for the choice to remove such access devices.

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Section: Burying the Pd Cathetermentioning

confidence: 99%

Interventional Nephrology and Dialysis: Chronic Peritoneal Dialysis Catheters: Overview of Design, Placement, and Removal Procedures

Ash

2003

Seminars in Dialysis

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“…Moncrief et al (77) devised a placement technique in which the entire peritoneal catheter can be buried under the skin some weeks to months before it is used. The catheter burying technique was first described for placement of a modified Tenckhoff catheter with a 2.5‐cm‐long superficial cuff, but the technique has been adopted for standard dual‐cuff Tenckhoff catheters (78–80). In the original technique, the external portion of the catheter was brought through a 2–3 cm skin exit site (much larger than the usual 0.5 cm incision).…”

Section: Burying the Pd Cathetermentioning

confidence: 99%

American Society of Diagnostic and Interventional Nephrology Section Editor: Stephen Ash: Peritoneal Dialysis Access‐Related Procedures by Nephrologists

Asif

2004

Seminars in Dialysis

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Traditionally the placement of a peritoneal dialysis (PD) catheter in a patient with end-stage renal disease (ESRD) has been accomplished by a surgeon and using general anesthesia. This approach often introduces delays in starting PD, incurs additional costs in utilizing an operating room as well as anesthesia services, and introduces the mortality risk associated with general anesthesia. Recent data have emphasized that interventional nephrologists can safely and successfully perform PD access procedures. In this context, operating room facilities and staff and anesthesia services are not required and catheter insertion can be performed in a procedure room using local anesthesia, thereby reducing costs and completely bypassing the mortality risk associated with general anesthesia. When performed by a nephrologist, the catheter insertion can be accomplished swiftly and dialysis therapy initiated in a timely manner. Once begun, the success of PD hinges on reliable and long-term access to the peritoneal cavity. Prospective randomized and nonrandomized studies have shown that PD catheters peritoneoscopically placed by nephrologists have fewer complications (infection, exit site leak) and longer catheter survival rates than those inserted surgically. Although PD offers a variety of advantages, it remains an underutilized form of renal replacement therapy. To counteract PD underutilization, at least two separate centers have demonstrated a positive impact on the growth of the PD population when catheter insertion is performed by nephrologists. This article presents PD access-related procedures currently performed by interventional nephrologists. Furthermore, some of the complicating issues (bowel perforation, catheter migration, prior abdominal surgery) related to PD catheter insertion and management are also discussed.

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“…Results show that the rate of ESI is reduced by 60% with SSPM implants in a 2 month observation period. 54…”

Section: Seare's Spatially Specific Porous Biomaterials Implantmentioning

confidence: 99%

Exit‐site and catheter‐related infections in peritoneal dialysis: Problems and progress

Dasgupta

2000

Nephrology

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SUMMARY: Silastic peritoneal catheters are used routinely for peritoneal access in peritoneal dialysis (PD) because they are biocompatible. Catheter insertions are usually succeeded by bacterial adhesion and subsequent colonization of the catheter exit site. Despite the reduction in the proportion of peritonitis due to touch contamination, exit‐site and catheter‐related infections, particularly those caused by Staphylococcus aureus, remain the major cause of catheter loss and technique failure in PD. The peritonitis rate in the global PD population is steadily declining, but as the number of patients on PD increases by about 10% per year the stakes in infection control become greater, and one is forced to consider new options that will reduce the PD patient drop‐out rate. Three areas of promising advances in the prevention of exit‐site and catheter‐related infections are reviewed in this paper: (i) the use of prophylactic antibiotics to eliminate the nasal carriage of Staph. aureus and to reduce exit‐site infections; (ii) the Moncrief–Popovich catheter and implantation technique which reduces bacterial colonization of the catheter exit tunnel; (iii) new catheter implants composed in part of rigid biomaterials with antibacterial properties. This last category includes the silver‐coated silastic PD catheter, significant not only because it has great potential as a replacement for the silastic catheter, but also because it is a reminder that caution must be exercised before fully embracing new treatment options.

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Peritoneal Dialysis Access Technology: The Austin Diagnostic Clinic Experience

Cited by 15 publications

References 3 publications

Interventional Nephrology and Dialysis: Chronic Peritoneal Dialysis Catheters: Overview of Design, Placement, and Removal Procedures

Interventional Nephrology and Dialysis: Chronic Peritoneal Dialysis Catheters: Overview of Design, Placement, and Removal Procedures

American Society of Diagnostic and Interventional Nephrology Section Editor: Stephen Ash: Peritoneal Dialysis Access‐Related Procedures by Nephrologists

Exit‐site and catheter‐related infections in peritoneal dialysis: Problems and progress

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