Failure of Peritoneal Catheter CUFF Shaving to Eradicate Infection

Often the catheter is lost when exitsite infections fail to resolve with antibiotic therapy. Excision of the external cuff has been proposed as an alternative to catheter removal. Prospectively we recorded the results of 22 cuff-shaving procedures and all subsequent CAPD-related infections. After the cuff shaving we encountered six dialysate leaks, which resulted in catheter removal. In 10 other patients, four developed peritonitis, four tunnel infection and two recurrent exit..site infection with the same micro-organism that caused the original exit site infection. Cuff shaving did not decrease the exit-site infection and peritonitis rates. Median catheter survival time after the cuff shaving was 1.5 months (range from 0 to 23 months). In conclusion, cuff shaving often fails to eradicate catheter infection. We need to develop alternative methods for treating and preventing exit-site infections.