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Silver-Impregnated Dressings for Catheter Exit-Site and Tunnel Infections in Peritoneal Dialysis Patients
Sponsor: Singapore General Hospital
Summary
The goal of this clinical trial is to evaluate the feasibility and acceptability of using silver-impregnated dressings, compared to standard daily topical antibiotic exit-site dressings, for the management of catheter exit-site infection or tunnel infection in adult patients undergoing peritoneal dialysis. The study also aims to explore infection resolution, safety, and clinical outcomes associated with this alternative exit-site care approach. The main questions it aims to answer are: Is the use of silver-impregnated dressings feasible and acceptable for peritoneal dialysis patients with exit-site or tunnel infection? Does the use of silver-impregnated dressings result in faster resolution of catheter exit-site or tunnel infection? Does replacing daily topical antibiotic dressings with silver-impregnated dressings reduce the frequency of dressing changes and the time spent on exit-site care? Are there any adverse events associated with the use of silver-impregnated dressings? What infection-related clinical outcomes occur, including recurrence of infection, need for catheter removal, or infection-related hospitalisation? Standard management of catheter exit-site or tunnel infection typically includes daily exit-site cleansing, application of topical antibiotics, sterile dressing coverage, and systemic antibiotic therapy. Despite these treatments, some patients continue to experience persistent or recurrent infections and adverse outcomes such as peritonitis, catheter loss, or transfer to haemodialysis. Participants will: Be randomly assigned to receive either silver-impregnated dressings or standard exit-site care with daily topical antibiotic dressings as alternative approaches to local exit-site management Continue to receive systemic antibiotics according to current clinical guidelines Attend regular clinic visits for exit-site assessment and monitoring Be followed for up to twelve weeks to evaluate feasibility, safety, patient experience, and infection-related outcomes The results of this pilot study will help evaluate whether silver-impregnated dressings are a feasible and acceptable alternative to standard topical antibiotic exit-site dressings for managing catheter-related infections in peritoneal dialysis patients and will inform the design of future larger clinical studies.
Official title: Silver-Impregnated Dressings for the Management of Catheter Exit-Site Infection or Tunnel Infection in Peritoneal Dialysis Patients: A Pilot Study
Key Details
Gender
All
Age Range
21 Years - 90 Years
Study Type
INTERVENTIONAL
Enrollment
60
Start Date
2026-06
Completion Date
2027-03
Last Updated
2026-06-11
Healthy Volunteers
No
Conditions
Interventions
Silver-Impregnated Dressing
A silver-impregnated dressing being evaluated for the management of peritoneal dialysis catheter exit-site or tunnel infection. The dressing provides antimicrobial activity through the presence of silver ions and will be applied to the catheter exit site following routine cleansing with an appropriate antiseptic solution. Dressing-change frequency will be guided by clinical assessment of exudate and infection status and is generally less frequent than daily changes during active infection. The silver-impregnated dressing is used as an alternative to standard daily topical antibiotic exit-site dressings as part of local exit-site care. Participants will continue to receive systemic antibiotic therapy according to institutional practice and clinical guidelines.
Standard Exit-Site Care With Topical Antibiotic Dressing
This intervention consists of standard institutional peritoneal dialysis catheter exit-site care for the management of exit-site or tunnel infection. Exit-site care includes routine cleansing with antiseptic agents, application of topical antibiotic ointment (such as gentamicin or mupirocin), and coverage with a standard dressing. Dressing changes are performed daily or as required according to usual clinical practice. This intervention represents standard care and serves as the comparator for evaluating the feasibility of the silver-impregnated dressing. Systemic antibiotic therapy, is provided according to institutional practice and clinical guidelines.
Locations (1)
Singapore General Hospital
Singapore, Singapore