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OUTCOMES OF BUTTONHOLE AND ROPE‐LADDER CANNULATION TECHNIQUES IN A TROPICAL RENAL SERVICE
Author(s) -
Smyth Wendy,
Hartig Vicki,
Manickam Valli
Publication year - 2013
Publication title -
journal of renal care
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.381
H-Index - 27
eISSN - 1755-6686
pISSN - 1755-6678
DOI - 10.1111/j.1755-6686.2013.12020.x
Subject(s) - medicine , attendance , fistula , dialysis , arteriovenous fistula , surgery , cohort , physical therapy , economics , economic growth
SUMMARY Background Buttonhole cannulation was introduced into this Queensland Renal Service in 2005. Contrary to published literature, a local review of cannulation outcomes found no greater likelihood of infections with the buttonhole technique. Objectives To compare the outcomes of buttonhole and rope‐ladder cannulation techniques. Design Prospective cohort. Participants Consenting patients attending for haemodialysis via an existing arteriovenous fistula (n = 104). Measurements Cannulation sites were assessed at every dialysis session for 12 weeks; fear and pain were scored by participants weekly. Results No statistically significant differences in infection, haematoma formation, pain or fear between the techniques. Occurrence of aneurysm was higher (p < 0.05) in the rope‐ladder group. More patients in buttonhole group required multiple cannulation attempts (p < 0.05). More of the rope‐ladder group failed to attend their scheduled dialysis sessions (p < 0.05). Conclusions and applications to practice This study confirms that in this setting there are few negative outcomes of either technique of fistula cannulation. Specifically, buttonhole cannulation appears to be a safe alternative means of fistula access to the gold‐standard cannulation technique. The Service is examining strategies to improve attendance.