Cannulating AV Fistulae - The Buttonhole Technique
© 1997 Andrew Lundin, M.D. All rights
reserved. Reproduced with permission.
How does the buttonhole work?
It means using the same exact site over and over so that
painless needle path or tunnel forms. As I said earlier,
I have three
arterial and three venous sites. They are paired to all
between the intake of blood and the return. If the tissue
hole remains undisturbed (not punctured) it remains strong
tunnel plugs up quickly when the needles are removed. I
do not have
prolonged bleeding despite many years of use. If the needles
around the same area then the tissues are broken down and
aneurysms can form.
I removed the scabs from sites that I will stick. I wash
my hands and
access arm with soap and water thoroughly. Then I apply
wait a few minutes for it to dry, then alcohol and let
it dry before
sticking. I have not had a single access infection in the
many years of
I do not believe this technique should be used on grafts.
have any successful experience?
Peter Lundin, M.D.
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