Wcn24-1116 Guidewire Exchange Non-Tunneled Catheter With Skin Marsupialization at the Entry Site Switch to Hemodialysis Tunneled Catheter, Technique Review

In Mexico, the patients with CKD in hemodialysis, a large percentage of patients have a prolonged use of non-tunneled catheter as vascular access, most of the patients had catheter placed in an emergency room and did not have follow-up by nephrology. The KDOQI recommendations suggest changing non tunneled catheter to a tunneled catheter no later than a week, In our unit patients who arrive with a non-tunneled catheter are changed to a tunneled catheter. we have observed that a non-tunneled catheter with prolonged use causes marsupialization of the skin at the catheter entry site (see pic1), so it is not possible to perform the procedure with guidewire catheter exchange due to the risk of externalization of the catheter and wound dehiscence(see pic2), we performed a skinplasty technique on the entry site to be able to perform guidewire exchange technique and allows the same venotomy.