Although limited data are available (1), we observe in our daily practice that many patients with percutaneous urinary drains, such as nephrostomy catheters or suprapubic catheters, experience dermatological complications around the catheter insertion site. 0.1% Polyhexanide-Betaine wound gel (Prontosan®) contains 0.1% polyhexanide and 0.1% betaine surfactant, which has been widely used for the management of various types of wounds.(2) The gel functions by disrupting and preventing the formation of biofilm on wound beds, suggesting its potential as a therapeutic option for addressing skin issues associated with urinary catheters. This pilot study aims to evaluate the efficacy of 0.1% Polyhexanide-Betaine wound gel in treating dermatological complications around the catheter insertion sites in affected patients.

Patients presenting with dermatological complications (such as redness, irritation, pain, pruritus, odor or discharge) were identified during routine outpatient visits for drain replacements. A baseline photograph of the catheter insertion site was taken on day 0, and relevant skin issues were documented in the patient’s medical record. Patients with nephrostomy tubes received the wound gel at the outpatient clinic during the initial visit and subsequently during weekly dressing changes. Patients with suprapubic catheters were instructed to apply the gel to the catheter insertion site daily. Patients were contacted on day 21 to assess the status of their skin condition. In cases where improvement was noted, 0.1% Polyhexanide-Betaine wound gel therapy was continued. Statistical analysis was performed using the McNemar’s test.

A total of 43 patients were included in the study, consisting of 25 patients with nephrostomy tubes and 18 patients with suprapubic catheters. Two patients discontinued 0.1% Polyhexanide-Betaine wound gel therapy at  day 21: one due to an allergic reaction and the other due to catheter dislocation, which was the cause of the symptoms. One patient reported side effects associated with 0.1% Polyhexanide-Betaine wound gel.

All complications, except for pruritus, improved significantly over the course of three weeks. Overall, 81.4% of the patients expressed satisfaction with the management of their skin issues after three weeks of treatment. 0.1% Polyhexanide-Betaine wound gel has potential to improve quality of life of patients with percutaneous urinary catheters.

0.1% Polyhexanide-Betaine wound gel is an easy-to-use and efficient therapy for managing dermatological complications at the insertion site of percutaneous nephrostomy tubes and suprapubic catheters.

1. Hunter KF, Bharmal A, Moore KN. Long-term bladder drainage: Suprapubic catheter versus other methods: a scoping review. Neurourol Urodyn. 2013;32(7):944-51.
Lazzari G, Cesa S, Lo Palo E. Clinical use of 0.1% polyhexanide and propylbetaine on acute and hard-to-heal wounds: a literature review. J Wound Care. 2024;33(Sup6a):cxl-cli.