Exit Site Trouble

[Ken Shelmerdine]

On New Years Eve (daytime) I was changing the dressing on my exit site and I did the usual pressing round the exit area to check against infection and and a kind of light grey fluid oozed out from the exit surrounding the tube, (sorry this is gross don't read this while your eating) and I also noticed some swelling  for about 2 inches where the tube runs under the skin. The more I pressed the more fluid came out. I thought 'shit an infection' so I drove to my PD drop in clinic about 4 miles from my home and they took a swab and sent it the the lab and sent me home with an antibiotic.

Today I phoned the clinic for the result and the nurse said it tested negative. No infection which I'm relieved about. It is still discharging very slightly so I'm just keeping it as clean as possible and changing the dressing every day instead of every two.

The question is though if it's not an infection, what the hell is it? Has anyone else experienced this?

[Chicken Little]

My guess would be that it's just shower water.  That happens to me.   I'll completely dry off and sit down to bandage, then notice a drizzle rolling down my stomach under the exit site.  My nurse told me not to be concerned and just be extra diligent in drying off the area.   

[okarol]

Found this at http://www.kidney.org.uk/Medical-Info/pd/pdproblems.html:

Catheter/Drain Problems

Leak of PD fluid: In most people, the ‘seal’ around the catheter exit site (where the catheter leaves the abdomen) works properly. PD fluid drains in and out of the abdomen through the tube without any leakage. However, in some people, the PD fluid leaks out around the catheter, wetting the dressing over the exit site.

If a leaking catheter is ‘rested’ (not used for dialysis) for 2 to 4 weeks, it will usually ‘seal up’ again, and become watertight. Occasionally, however, a leak may recur even if the catheter is rested. It may then be necessary to have an operation to take out the leaking catheter. A new catheter, at a different site, is usually put in during the same operation.

[KICKSTART]

Mine has never been right ! Despite showing them at the hospital , i get a lumpy scab forms every few days, which when i clean my exit site comes off but bleeds. Its not granulation , but the hospital have never bothered. When you have cleaned your exit site do you not apply antibacterial cream ? maybe that would help protect it ?

[Wattle]

Ken,

Do you use an antibacterial cream in the shower to clean the area? What is your dressing routine? I have always had mine covered, apart from in the shower when it is washed with Deb Green Antibacterial soap. I then dry it off well with its own towel ( I use face washers, a new one each time). It is then anchored with tape and covered with a dressing.

You may have given it a tug without realizing and it has swollen and weeped a little from the trauma. Always use an anchor tape.

I hope it has cleared up. 

[Ken Shelmerdine]

Ken,

Do you use an antibacterial cream in the shower to clean the area? What is your dressing routine? I have always had mine covered, apart from in the shower when it is washed with Deb Green Antibacterial soap. I then dry it off well with its own towel ( I use face washers, a new one each time). It is then anchored with tape and covered with a dressing.

You may have given it a tug without realizing and it has swollen and weeped a little from the trauma. Always use an anchor tape.

I hope it has cleared up. 

I use bactroban cream each time I change the dressing which is antibacterial. I always shower with the dressing on and then replace it afterwards. Maybe it was trauma because I'm always scratching at it as it gets so itchy under the dressing. But I think maybe Carol's explanation might be the true cause. I never new that PD fluid could come back through the tube tunnel.

Thankfully it seems to have cleared up now.

[Wattle]

   Thats great Ken