How to care for your Peritoneal Dialysis (PD) Catheter

What is a PD catheter used for?

A PD catheter is a tube that is surgically placed in the abdominal cavity. This catheter enables a connection to be made to a dialysis bag. Special dialysis fluid can enter and drain out of the abdominal cavity via this catheter.

What is an exit site?

It is important to keep your exit site as dry as possible.

It is better to have a shower rather than a bath.

If you would like to go swimming this may be possible. Please discuss this with your home therapies nurse or doctor first.

How should I clean my exit-site?

Your exit-site should be cleaned every day and antibiotic ointment or cream applied to the new dressing to reduce the risk of getting an infection.

Shower with the dressing on. After your shower, adhere to the following instructions to clean the exit site and re-apply a new dressing. Do not dry your exit site with your towel.

1. Remove existing dressing and then wash and dry your hands.
2. Clean work surface with antiseptic wipe.
3. Open the cover of a new dressing and then clean your hands with the wipes.
4. Dry your exit site with the sterile gauze as required
5. Using a new antiseptic wipe, fold the edges together to form a parachute shape. (See diagram below.) If you touch the centre of the wipe discard it and use a new one.

6. Use one parachute for each full circular wipe of the exit site, using two to three new wipes as necessary. (See diagram below). Allow 30 seconds for the alcohol to dry off.

7. Put a pea sized amount of antibiotic ointment or cream in the middle of the dressing. (See diagram below). Apply a tube holder to secure your catheter to minimise movement.

8. It is very important to make sure your catheter is well secured. This can be achieved by using tape to stop movement of the catheter at the exit-site. We also advise you to loop your catheter (to make a ‘c’ shape) before placing your dressing on. This allows a little give if you do accidentally pull on your catheter. Pulling the tube disturbs the surface of the skin around the exit-site and this makes it easier for germs to start growing and an infection to develop. Trauma or irritation to your exit-site can also be caused by rubbing of clothing.

Exit site infections

An exit-site infection is the presence of a germ(s) around the exit-site of your tube. Germs like warm, moist places to grow therefore it is important to keep your exit site clean and dry. If you have an infection you may notice:

• A discharge of pus
• Redness
• Soreness
• Swelling / inflamed

If you notice any of the above symptoms you must contact Home Therapies or C5 Ward and let the nurses know.

Contact numbers:

Monday to Friday 08.30 to 17.00 home therapies department: 01223 400184

Out of office hours ward C5: 01223 217195

(please ask your nurse for the How to contact a PD home therapies nurse contact sheet).

What treatment will I need if I have an exit site infection?

The home therapies nurse will take a sample of the discharge from your exit site onto a swab to find out if there is a particular infection there. If an infection is suspected, you will be seen by a doctor and be prescribed some antibiotics to take home. It is important to take the whole course of antibiotics even if the symptoms get better. If you stop taking the antibiotics too early the germs may start growing again. Please tell the doctor or nurse if you are allergic to any antibiotics or get any side-effects from taking the treatment. You will be asked to come back to the dialysis unit to see a home therapies nurse, who will check your exit-site and make sure the infection has cleared up. Do not have a bath / shower or go swimming if your exit-site is sore or infected.

What if the infection doesn’t get better?

Some germs are very troublesome if they start growing around your exit site. An exit-site infection could lead to peritonitis (infection of the peritoneal membrane). If this happens your dialysis fluid will become cloudy and you may get tummy ache and you will need immediate treatment at the hospital. Some catheters will need to be removed if the infection does not go away. It is therefore important to check your exit-site daily for sign of infection and get any problems treated as soon as your notice them.

What can I do to reduce the risk of getting an infection?

1. Always wash your hands well before cleaning your exit-site and dry them properly.
2. Keep your exit-site and dressing dry; germs love wet and warm areas to grow.
3. Clean your exit-site as shown during your training every day to check it is healthy.
4. Apply the prescribed cream or ointment onto your exit-site daily as instructed.
5. Always shower with your dressing on and clean exit-site immediately after you finish showering.
6. If you are having a bath or going swimming you must use the protective Activity Pouches which your GP can prescribe for you. These reduce the risk of a germ coming into contact with your catheter. The home therapies staff can show you how to use this protective pouch.
7. Do not bath / shower or swim if your exit-site is sore, bleeding or infected.
8. Make sure your catheter is well secured. This can be achieved by using tape or a special PD catheter belt to stop movement of the catheter at the exit-site.
9. Try to prevent trauma or irritation to your exit-site. This can be caused by rubbing of clothing or pulling of the catheter.

Contacts and further information

Please do not hesitate to contact us if you are in any doubt or if you notice any changes.

Contact telephone numbers:

Monday – Friday 08:30 to 17:00 home therapies tel. 01223 400184
Evenings and weekends ward C5 tel. 01223 217195