Presternal catheter design--an opportunity to capitalize on catheter immobilization.

Effective immobilization of the peritoneal catheter has repeatedly been associated with positive catheter-related outcomes. This single-center retrospective community study compared infectious complication rates for peritoneal catheters that exit from a highly mobile structure (the abdomen) with rates for catheters exiting from a structure with minimal associated motion (the chest). Data were collected between January 1, 2005, and January 31, 2010. Patients undergoing catheter implantation were divided into two groups: 22 patients with 23 abdominal catheters; 21 patients with 22 presternal catheters. The abdominal and presternal groups were similar, with the exception of catheter experience (410.4 months and 187.2 months respectively), and mean body mass index (BMI--26.2 kg/m2 and 29.1 kg/m2 respectively). Catheter-related infections prompted removal of 2 abdominal catheters. No presternal catheters had to be removed. For abdominal and presternal catheters respectively, the rates of exit-site infection were 0.22 episodes/ patient-year and 0.11 episodes/patient-year (p = 0.73), and the incidences of peritonitis were 0.41 episodes/patient-year and 0.27 episodes/patient-year (p = 0.63). The more effective catheter immobilization on the chest may lower the frequency of infectious complications.