Negative-Pressure Wound Therapy is Effective for Peritoneal Dialysis Catheter Exit-Site Management in The Early Postoperative Period

Abstract Peritoneal dialysis (PD) catheter exit-site care is critically important for the prevention of catheter-related infections (CRIs) and subsequent peritonitis. The postoperative management of the site is particularly essential due to its susceptibility to slow healing and infection. Despite the recent use of negative-pressure wound therapy (NPWT) for a wide variety of wounds, few studies have investigated the effectiveness of NPWT for PD catheter exit sites. In this study, 30 patients with end-stage renal disease who underwent simultaneous PD catheter insertion and exit-site formation were randomly assigned to receive NPWT (NPWT group) or conventional dressing (non-NPWT group) for the first seven postoperative days. The exit-site scores on the seventh postoperative day and over 180 days were lower in the NPWT group than in the non-NPWT group (p = 0.0049 and p = 0.007, respectively). There were no statistically significant differences between the time to first CRI and PD-related peritonitis between the two groups. There was one case of CRI with relapsing peritonitis and catheter loss in the non-NPWT group. These findings demonstrate the association between NPWT and low exit-site score. NPWT can be recommended for the management of PD catheter exit sites in the early postoperative period.