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Central venous catheters (CVCs) are increasingly used for vascular access in hemodialysis patients. One of the major complications of CVCs is infection. The purpose of this randomized clinical trial was to determine if ExSept® was as effective as Chlorhexidine in reducing skin colonization, exit site, and central venous catheter-related blood stream infections. Patients with new dialysis catheters (n=121) were randomly assigned to the Chlorhexidine group or the ExSept® group. The duration of the study was 3 months per patient or until the development of an infection. Major outcome observations of the study were: 10 exit site infections (5 per group), 2 episodes of bacteremia (1 in the Chlorhexidine group and 1 in the ExSept® group), and 91.7% skin colonization. The conclusions drawn from this study are that infection rates were low in this cohort and ExSept® and Chlorhexidine had comparable efficacy.o embrace this approach, to enter the mutual relationship it requires, and to maximize positive outcomes for patients with ESRD.                                                                                     

Colleen Marie Astle, MN, RN, CNeph(C), EPN, is Dialysis Access Coordinator, Nephrology Nurse Practitioner, University of Alberta Hospital, Edmonton, Alberta, Canada.
Louise Jensen, RN, PhD, is Professor, Faculty of Nursing, University of Alberta, Edmonton, Alberta, Canada.