Document Detail


A timesaving method to create a fixed puncture route for the buttonhole technique.
MedLine Citation:
PMID:  13679489     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: Up to now, for a successful buttonhole puncture of the vascular access vessel, the fistula should be punctured by the same experienced medical staff for 2-3 months, using sharp needles, until a fixed puncture route is established. METHODS: We developed a timesaving method to create the fixed puncture route for the buttonhole technique. In this method, after the usual haemodialysis (HD), a newly developed thumbtack-shaped polycarbonate peg is thrust toward the access vessel along the same path as the puncture needle that has just been removed. Then, at the beginning of the next HD, the peg is removed and a dull puncture needle is inserted along the track already formed by the peg left in place. These steps are repeated at each HD session for 14 days. Thereafter, the vascular access is achieved at HD sessions by inserting a dull puncture needle through the established puncture route. RESULTS: This buttonhole puncture approach was used in 37 patients for 3 months. While the polycarbonate peg was in place, patients experienced no restrictions in their normal activities of daily living, except during bathing and showering. As for puncture pain, no patient found the pain of the buttonhole technique to be greater than that of the conventional puncture technique. Moreover, no significant bleeding was noted during HD. With this buttonhole puncture approach, only one patient had enough erythema at the puncture site to suggest possible infection. After HD, the time for bleeding to stop was <10 min in 95% of patients. CONCLUSION: This study showed the new timesaving method for creating a buttonhole to be safe and useful.
Authors:
Shigeki Toma; Takahiro Shinzato; Hiroyoshi Fukui; Shigeru Nakai; Masamiki Miwa; Ichiro Takai; Kenji Maeda
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Publication Detail:
Type:  Comparative Study; Journal Article    
Journal Detail:
Title:  Nephrology, dialysis, transplantation : official publication of the European Dialysis and Transplant Association - European Renal Association     Volume:  18     ISSN:  0931-0509     ISO Abbreviation:  Nephrol. Dial. Transplant.     Publication Date:  2003 Oct 
Date Detail:
Created Date:  2003-09-18     Completed Date:  2004-02-06     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  8706402     Medline TA:  Nephrol Dial Transplant     Country:  England    
Other Details:
Languages:  eng     Pagination:  2118-21     Citation Subset:  IM    
Affiliation:
Toma Clinic, 972 Aza-Kochi, Nishihara-cho, Nakagami-gun, Okinawa Prefecture, Japan. stoma@air.linkclub.or.jp
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MeSH Terms
Descriptor/Qualifier:
Catheters, Indwelling*
Humans
Kidney Failure, Chronic / therapy
Punctures
Renal Dialysis / instrumentation,  methods*
Safety
Sensitivity and Specificity
Time Factors

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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