Your Incision and Dressings
Depending on what kind of dialysis access surgery you have had, you now have a dressing or two dressings, and possibly an incision that needs to heal before dialysis can begin. It is important to take care of your dressings and incision in order to prevent infection. Closely monitor any changes and if you have questions or concerns, please call your dialysis access nurse coordinator.
Peritoneal Dialysis Catheter Dressing Instructions
Do not change or remove the surgical dressing. You may put clean gauze over the area if you wish, but do not take off the dressing that is there. Remember, if the dressing is soaked with blood or a thick, yellowish discharge (pus), please call your dialysis access nurse coordinator.
In most cases, there are no stitches that need to be removed.
Do not shower, take a tub bath, or allow the dressing to become wet until you speak with your PD nurse at your next appointment (about one week after your access surgery).
If the dressing becomes wet, blood-soaked or falls off, call your dialysis access nurse coordinator.
Hemodialysis Permacath Dressing Instructions
You may have a small dressing over your neck incision. Your dialysis nurse may change this dressing after two days. You should keep a dressing over this incision until the wound heals, usually about 7 to 10 days. The nurses in the dialysis unit will change this dressing for you as needed.
The neck incision does not have stitches or sutures. You may see some small paper stitches called steri-strips. These will fall off on their own, or will be removed when you see your doctor about two weeks after your access surgery.
The nurses in the dialysis unit will also change the dressing on your chest.
Please do not let anyone else change this dressing. The nurses will ask you to wear a mask when the dressing is changed to help prevent infection in this sensitive area. The dressing will remain over this area for as long as you have your permacath.
There is also a stitch at the catheter site in your chest. The dialysis nurse or your surgeon will remove this stitch about three weeks after your access surgery.
It is important that you never get the dressing on your chest wet. You should not shower or swim with a permacath in place. It is okay to take a tub bath, as long as you do not get the dressing wet. This is very important because bacteria can grow easily in a wet, moist environment. If bacteria begins to grow around your permacath, they could cause a serious infection at the site or in your bloodstream.
Try not to push or pull on the catheter especially in the first three weeks. Do not do anything that causes stretching or strain in the area.
Hemodialysis Fistula or Graft Dressing Instructions
Keep the dressing dry for two days. Do not change the dressing during this time. A small amount of drainage on the dressing is okay. You may cover the area with a clean gauze pad if you wish, but leave the dressing underneath for two days.
After two days, you may remove the dressing. You may then bathe or shower as usual. After your bath or shower, pat the area over the fistula or graft gently with a towel. Do not rub the area.
In most cases, the wound over the fistula or graft is closed with internal stitches that do not need to be removed. You may see small paper strips called steri-strips over the wound. These strips will fall off on their own in about 7 to 10 days. (If they fall off sooner that is okay - check to make sure the wound is not opening.)
Some redness directly around the incision is normal. If there is redness or warmth increasing or spreading, please contact your dialysis access nurse coordinator.
If you notice thick drainage coming from the wound, or if the edges of the wound start to separate, please contact your dialysis access nurse coordinator.