Based on the hypothesis that air contamination is an important cause of peritonitis in continuous ambulatory peritoneal dialysis, a simple and cheap connection system was developed whereby a clear polyethylene bag containing an antiseptic gauze was used as a sterilising chamber, effectively enclosing the connection procedure. Seven modifications to the connection technique were introduced over 32 months in 28 patients during 27-9 patient years of experience. The overall rate of peritonitis was 0-6 episode/patient year, but after a final modification at the beginning of the third year the rate fell to 0-17, without a single case of peritonitis occurring attributable to a connection failure in 11-5 patient years.These findings show that in patients receiving continuous ambulatory peritoneal dialysis peritonitis may be prevented by enclosing the connection process and sterilising the introduced air and tubing ends.
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