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buttonhole cannulation

Line Dahlstrøm Christensen, Mai-Britt Skadborg, Agnete H Mortensen, Carsten Mortensen, Jens K Møller, Lars Lemming, Irene Høgsberg, Steffen E Petersen, Niels H Buus
BACKGROUND: The buttonhole cannulation technique for arteriovenous fistulas is widely used, but has been associated with an increased rate of vascular access-related infections. We describe the frequency and type of bacterial colonization of the buttonhole tract over time and associated clinical infections. STUDY DESIGN: A prospective observational cohort study with 9 months of follow-up. SETTING & PARTICIPANTS: 84 in-center hemodialysis patients using the buttonhole cannulation technique at 2 Danish dialysis centers...
March 29, 2018: American Journal of Kidney Diseases: the Official Journal of the National Kidney Foundation
Clara K Poon, Christopher T Chan
Home hemodialysis (HHD) is emerging as an important alternate renal replacement therapy. Although there are multiple clinical advantages with HHD, concerns surrounding increased risks of infection in this group of patients remain a major barrier to its implementation. In contrast to conventional hemodialysis, infection related complication represents the major morbidity in this mode of renal replacement therapy. Vascular access related infection is an important cause of infection in this population. Use of central vein catheters and buttonhole cannulation in HHD are important modifiable risk factors for HHD associated infection...
April 2017: Hemodialysis International
Michael A Kraus, Sheru Kansal, Michael Copland, Paul Komenda, Eric D Weinhandl, George L Bakris, Christopher T Chan, Richard J Fluck, John M Burkart
Although intensive hemodialysis (HD) can address important clinical problems, increasing treatment also introduces risks. In this review, we assess risks pertaining to 6 domains: vascular access complications, infection, mortality, loss of residual kidney function, solute balance, and patient and care partner burden. In the Frequent Hemodialysis Network (FHN) trials, short daily and nocturnal schedules increased the incidence of access complications, although the incidence of access loss was not statistically higher...
November 2016: American Journal of Kidney Diseases: the Official Journal of the National Kidney Foundation
Abhilash Koratala, Kawther F Alquadan, Volodymyr Chornyy, Irfan Qadri, Abutaleb Ahsan Ejaz
No abstract text is available yet for this article.
March 21, 2017: Journal of Vascular Access
Pierpaolo Di Nicolò, Marina Cornacchiari, Marco Mereghetti, Anna Mudoni
As a consequence of the central role of the arteriovenous fistula for dialysis (AVF) in the clinical management of the dialysis patient the necessity to limit the puncture-related complications to extend as much as possible the life of the vascular access. Accordingly, the AVF needling technique has gained growing attention. Alongside the traditional rope ladder (RL) puncture method, the buttonhole technique (BH) is increasingly popular; this technique employs the same cannulation sites of AVF in every dialysis associated with the use of dull needles to minimize vessels damage...
January 2017: Seminars in Dialysis
Annie-Claire Nadeau-Fredette, David W Johnson
Successful cannulation of arteriovenous fistulas (AVFs) using a safe and effective technique that minimizes patient harm is a crucial aspect of haemodialysis treatment. Although the current standard of care for many years has been the rope-ladder technique (using sharp needles to cannulate rotating sites across the entire AVF), a number of enthusiasts have recently advocated for the alternative method of buttonhole cannulation (using blunt needles to repeatedly cannulate the same site via a healed track) on the basis of putative, as yet unproven benefits...
April 2016: Nephrology, Dialysis, Transplantation
Laura Labriola, Michel Jadoul
Potential advantages of buttonhole (BH) cannulation over the standard rope-ladder technique have been claimed on the basis of small sized, potentially biased observational studies with a relatively short follow-up. On the contrary, randomized controlled trials (RCTs) show inconclusive or conflicting results. The uncertain benefit must thus be weighed against a definite increase in the infectious risk with the BH technique, which may not be completely abolished by preventative strategies. Awaiting the results of long-term studies (>2-3 years follow-up), the widespread use of the BH technique is not warranted, especially in busy in-centre haemodialysis (HD) settings with many rotating nurses...
April 2016: Nephrology, Dialysis, Transplantation
Gihad E Nesrallah
Arteriovenous fistulae remain the access of choice for most hemodialysis patients. However, several factors limit their uptake and long-term patency, resulting in suboptimal prevalent rates in many high-income countries. Patients place considerable value on the avoidance of vascular access complications, pain and disfigurement. The approach to cannulation is a modifiable practice that could improve patient-important outcomes, with buttonhole needling offering some theoretical advantages over the standard rope-ladder and area methods...
April 2016: Nephrology, Dialysis, Transplantation
Sophie Collier, Hala Kandil, Enat Yewnetu, Jennifer Cross, Ben Caplin, Andrew Davenport
Arteriovenous fistula (AVF) is the preferred access for hemodialysis (HD). Buttonhole (BH) needling has increased following the introduction of "blunt" fistula needles. Although some reported advantages for BH needling, others have reported increased infection risk. As such we reviewed our center practice, and the effect of both nasal screening and eradication and re-education and training programs. We audited the outcomes of 881 HD patients dialyzed between November 2009 and May 2012, divided into three groups: 175 dialyzing exclusively by central venous catheter (CVC), 478 exclusively by area needling AVF (AVF) and 219 by BH...
October 2016: Therapeutic Apheresis and Dialysis
Shigeki Toma, Takahiro Shinzato, Kunihiro Hayakawa
PURPOSE: In this study, we discuss a mechanism of development of access-related Staphylococcus aureus infections in patients on buttonhole (BH) method and logically construct a measure to prevent such infections on the basis of the mechanism. SUMMARY: S. aureus can colonize a BH track. Once S. aureus colonizes a BH track, access-related infections may develop when the equilibrium is upset between the factors of host resistance and a level of bacterial growth in a BH track...
2016: Blood Purification
Clémence Béchade, Tony Goovaerts, Philippe Cougnet, Laura Labriola, Michel Jadoul, Eric Goffin
BACKGROUND: Buttonhole cannulation (BHC) has been associated with a greater risk of arteriovenous fistula (AVF)-related infections and septicemia than the rope ladder cannulation (RLC) in in-center hemodialysis (HD). Such infections have never been studied in satellite HD units. STUDY DESIGN: Retrospective single center study. SETTING AND PARTICIPANT: All patients in our satellite HD unit using a native AVF from 1 January, 1990, to 31 December, 2012...
2015: PloS One
(no author information available yet)
No abstract text is available yet for this article.
January 2015: Nephrology News & Issues
Kunihiro Hayakawa, Daiki Sugiyama, Hiroaki Tanaka, Satoshi Shinohara, Takahiro Ohki, Akinori Muraoka, Masamiki Miwa
In Japan, use of a surgically superficialized brachial artery is recommended for vascular access in patients who are either unable to tolerate hemodialysis because of reduced cardiac function or who do not have vessels suitable for creation of an arteriovenous fistula. Superficializing a brachial artery involves relocating a portion of the artery into subcutaneous tissue and immobilizing the artery at that location. Superficialized artery access can result in certain serious complications, such as an aneurysm and/or stenosis...
2015: Contributions to Nephrology
Arnav Agarwal, Gihad Nesrallah
Buttonhole cannulation has drawn considerable interest in recent years, particularly with the proliferation of home hemodialysis. Touted benefits of this cannulation method include reduced pain, ease of use, reduced aneurysm formation, and overall greater patient satisfaction. However, recent studies have also suggested that systemic and local infection rates are higher with buttonhole cannulation compared with the standard rope-ladder method. In this review, we summarize recent systematic review findings and practice guidelines addressing the benefits and harms of buttonhole cannulation, and discuss the role of topical antimicrobial prophylaxis...
2015: Contributions to Nephrology
Shigeki Toma
BACKGROUND: A reason for the higher frequency of vascular access-related infections in buttonhole cannulation patients remains to be elucidated. If the higher frequency of infections is associated with a factor(s) inherent to the buttonhole method (e.g. existence of a buttonhole track or other factors), the frequency of such infections is expected to increase upon starting buttonhole cannulation. On the other hand, if the higher frequency of the infections is associated with a factor(s) developing secondarily while performing buttonhole cannulation for months or years (e...
2015: Contributions to Nephrology
Shoichi Sato, Takahiro Shinzato, Naoko Sakai, Katsuyuki Ohkuri, Masatomi Sasaki, Shigeru Nakai, Shigeki Toma
BACKGROUND: Vascular access-related infection is more frequent in patients using the buttonhole method for cannulation of the arteriovenous access for hemodialysis. Deformity of buttonhole entry sites is frequently observed among patients on the buttonhole method for extended periods of time. With deformed buttonhole entry sites, moreover, scabs are often incompletely removed at the time of buttonhole cannulation. METHOD: In 166 patients using the buttonhole method at Hino Clinic in Osaka, Japan as of June 30, 2014, the shapes of buttonhole entry sites were categorized into the following 3 types: flat, depressive deformity, and bulging deformity...
2015: Contributions to Nephrology
Masamiki Miwa, Noboru Ota, Chiyono Ando, Yukio Miyazaki
A trampoline effect may occur mainly when a buttonhole tract and the vessel flap fail to form a straight line. Certain findings, however, suggest another cause is when the vessel flap is too small. The frequency of the trampoline effect, for example, is lower when a buttonhole tract is created by multiple punctures of the arteriovenous fistula (AVF) vessel than when it is done by one-time puncture of the vessel. Lower frequency of the trampoline effect with multiple punctures of the AVF vessel may be due to enlargement of the initial puncture hole on the vessel every time the vessel is punctured with a sharp needle...
2015: Contributions to Nephrology
Jennie King
Cannulation, and in particular, skilled cannulation is the cornerstone to preserving the arteriovenous fistula, the lifeline for a patient receiving long-term hemodialysis therapy. The buttonhole cannulation method has seen a huge revival in the 2000s, but it can sometimes prove challenging to implement successfully. This chapter discusses and describes the method of creating a buttonhole tract using the BioHole® device (a sterile polycarbonate peg), and describes the associated advantages and disadvantages...
2015: Contributions to Nephrology
Tomonari Ogawa, Etsuko Harada, Yuki Kanayama, Atsuko Tanabe, Megumi Inamura, Tota Kiba, Taisuke Shimizu, Takatsugu Iwashita, Yosuke Tayama, Akihiko Matsuda, Hajime Hasegawa
The two reasons that patients desire buttonhole cannulation are avoidance of puncture pain and extension of arteriovenous fistula life. Despite the desire to receive buttonhole cannulation by many patients, medical staff at most local hemodialysis facilities tend to hesitate to implement the cannulation method. This method is used on patients in the dialysis unit at Saitama Medical Center, but tends to be discontinued for those patients upon their transfer to local hemodialysis facilities. Medical staff members of one local hemodialysis facility report the percentage of patients on the buttonhole method was 53% in 2007, but that it sharply decreased to 17% in 2013...
2015: Contributions to Nephrology
Madhukar Misra
The constant side method of access cannulation in hemodialysis, popularly known as the 'buttonhole' method, has an interesting history. Dr. Zbylut J. Twardowski, a Polish nephrologist, discovered this technique by pure serendipity in 1972. A patient with a complicated vascular access history and limited options for cannulation was repeatedly 'stuck' at the same sites by a nurse. Soon it was noticed that the cannulation at the same spot became easier with time. Since the needles were being reused, the sharpness of the needles decreased with time and the bluntness of the needle seemed to minimize the damage to the cannulation tract (another serendipity!)...
2015: Contributions to Nephrology
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