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J Ren Care. 2013 Sep;39(3):157-65. doi: 10.1111/j.1755-6686.2013.12020.x. Epub 2013 Jun 26.

Outcomes of buttonhole and rope-ladder cannulation techniques in a tropical renal service.

Author information

  • 1Tropical Health Research Unit for Nursing and Midwifery Practice, Townsville Hospital and Health Service, Townsville, Queensland, Australia. wendy_smyth@health.qld.gov.au

Abstract

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.

© 2013 European Dialysis and Transplant Nurses Association/European Renal Care Association.

KEYWORDS:

Buttonhole; Haemodialysis; Nursing; Research; Vascular access

PMID:
23799903
[PubMed - indexed for MEDLINE]
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