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The authors examined the incidence and influencing factors of exit site infections (ESIs) in patients using dual and triple lumen dialysis catheters. The prospective, randomized study was conducted at 11 centers. Data were analyzed on 473 patients randomized to receive 235 dual lumen catheters (DLCs) or 238 triple lumen catheters (TLCs). Results: ESIs occurred in 10 patients (2.1%). The number of intertreatment uses (p=0.006), total number of uses (p=0.009), and catheter placement duration (p=0.03) were significantly associated with the incidence of ESI in both treatment groups. Although patients with TLCs had a significantly higher inter-treatment use than patients with DLCs (p=0.04), no significant difference in the incidence of ESI was found (p=0.11).  Diabetic status and catheter insertion site were not found to be significantly related to ESI (p=0.09 and p=0.54, respectively), although a trend toward significance was noted for diabetic status. Conclusions:  Stringent exit site care by specially trained staff and shorter catheter duration most likely contributed to the low incidence of ESIs.  Other influencing factors included numbers of inter-treatment uses, total number of uses, and catheter placement duration.                                                                                     

Elizabeth J. Young, BSN, RN, CNN, is a Clinical Manager of Vascular Product Development in the Vascular Therapy Division, Tyco Healthcare/Kendall in Mansfield, MA; and a member of ANNA's Mass Bay Chapter.

Gabriel Contreras, MD, MPH,is an Associate Professor of Medicine in the Division of Nephrology and Hypertension at the University of Miami, Jackson Memorial Hospital, Miami, FL.

Nurian E. Robert, MBA, BSN, RN, CNN,is the Project Manager/Disease Case Manager, RMS Disease Management in Miami, Florida.  She is a graduate student at the University of Phoenix in the Nursing program and is secretary of the South Florida Flamingo Chapter of ANNA.

Nancy J. Vogt, MSN, BSN, BSEd, RN,is a staff nurse in the Emergency Room at Caritas Norwood Hospital in Norwood, MA, and is a private consultant in medical research.

Theresa M. Courtney, BSN, RN, is a Director of Clinical Affairs, Tyco Healthcare/Kendall in Mansfield, MA.