SHBC1491

S.H. TAN¹, C. SI¹, B. LIU1, M.E. LAIW¹, Y.C. LIM¹, S.M. LAU¹, M.P. BOEY¹, A.Y.L. LIU¹

Khoo Teck Puat Hospital¹

Exit-site infection (ESI) is one of the major predisposing factors to peritoneal dialysis (PD) related peritonitis. Chlorhexidine Gluconate (CHG) has been widely used for cutaneous disinfection for half a century. TegadermTM CHG is a water-proof dressing with gel pads that provide 2% CHG to the skin surface and effectively prevents catheter-related infections for intravascular catheters. However, its use has not been accessed in patients with PD catheters. We aim to evaluate the effectiveness of TegadermTM CHG dressing in the prevention of ESI in PD patients.

We conducted a prospective study on incident PD patients from October 2019 to July 2021. Participants used Tegaderm™ CHG dressing for 4-6 months. The dressing was changed every seven days or soiled. The incidence rate of ESI was compared with a historical cohort (November 2016 to October 2017) practising conventional exit site care with standard saline cleaning, daily 0.1% gentamicin cream and soft cloth dressing.

ESI occurred in 2 out of 24 patients who received TegadermTM CHG dressing (8.3%) versus 6 out of 38 patients (15.8%) from the historical cohort (p=0.39). Seven patients (32%) with TegadermTM CHG dressing developed localized irritation and rash; four of them (18%) required early termination of the study. No significant adverse events were observed.

Our study showed that TegadermTM CHG dressing could be an alternative to conventional daily saline cleaning and topical antibiotic cream application in preventing ESI. TegadermTM CHG dressing may offer advantages, including ease of application, a reduced frequency for change and possibly reinforcement on patient compliance.