Hautkontamination von Punktionsstellen bei Dialyse-Shunts - Ein Vergleich zweier Vorgehensweisen

摘要

Aim: The aim of this research is to discover a quantitative difference in colonisation of Dialysis-fistulas during renal replacement therapy if puncture sites are left open or covered with sterile gauze. Background: Handling of puncture sites during renal replacement therapy differs from organisation to organisation. This leads to ongoing discussions about the hygienically correct way.Method: 10 patients were recruited for this investigation. Three swabs from the venous puncture site were investigated. The first swab was taken before disinfection, the second after disinfection and a third after Dialysis treatment. Two different procedures were examined; a) puncture site is not covered; b) puncture site is covered with sterile gauze.Results: This examination showed that there is a significant difference in contamination between these two procedures. Puncture sites which had been covered with sterile gauze showed less colonisation after four to five hours of Dialysis treatment than those which had not been covered.Discussion: With the method "covered with sterile gauze" corresponding skin-areas show a significantly lower, bacterial colonization. Because of the limitations of this orienting study further research concerning this topic is required. However, until further inquiries are completed a recommendation can be concluded from these results.Recommendation: In order to minimize fistula colonization during Dialysis therapy, puncture sites should be covered with sterile gauze (dimensions 5 cm X 5 cm).