Bernstein SP, Griffin EM, Santiflia EM, Kurpen SA, Brady AB, McMahon MM
Prevention of exit-site infection with hypertonic saline
17th Annual CAPD Conference
Perit Dial Int Suppl 1 (Feb) 17:S92 1997

This study evaluated the use of saline soaks to prevent exit site infection. Seventy-one patients were studied during a 30-month period. All patients had single-cuff catheters in place. During the initial period, exit site care consisted of daily cleaning with a gauze soaked with normal saline. During the control period, hypertonic saline was used. Hypertonic saline was prepared by adding 2 tablespoons of table salt to a liter of sterie saline, giving a 2.25% NaCl solution.

With about 1000 patient months of follow-up in each group, there were 37 exit site infections during the period when normal saline was used vs. only 16 when hypertonic saline was used. The incidence figures were 1:29 vs. 1:66, respectively.

Comment: Problems: No analysis of exit-site infection (ESI). Were all patients new or did they have a history of previous ESI? Were only the first ESI counted? How was ESI treated? Nevertheless, this is an old surgical trick that seems worth a try. (Stephen Vas, M.D., University of Toronto, Canada)

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