KEY ACTIVITIES
Diagnostic:
- Perform physical exam including abdominal palpation, degree and location of pain, exit-site, and tunnel assessment
- Consider imaging studies for equivocal abdominal exam to evaluate for possible intra-abdominal abscess
- Send sample of peritoneal effluent for cell count
Therapeutics:
- Continue appropriate antibiotic coverage perioperatively2
- Insert new catheter (clean step) before removal of old catheter (dirty step)2
- Close watertight all penetrating points through musculofascial layers of abdominal wall2
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Utilize intermittent regimen of supine, low-volume PD during interval of postoperative recovery;2
leave peritoneum dry during ambulatory periods - Monitor for signs of infection or leak
