The buttonhole technique represents an arteriovenous fistula puncture tool that allows positioning the needle always at the same site. This procedure not only is more comfortable for patients, but is also appreciated by nurses because it reduces hemostasis time and offers the advantage of an easy cannulation.
The only negative outcome of the buttonhole technique is, possibly, an increased incidence of skin infections. We introduced the buttonhole technique at the dialysis centers of the Rimini Hospital in 2009 and we here investigate the results and complications recorded during the following 5 years.
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van LoonM.M., GoovaertsT., KesselsA.G., van der SandeF.M., TordoirJ.H.. Buttonhole needling of haemodialysis arteriovenous fistulae results in less complications and interventions compared to the rope-ladder technique.Nephrol Dial Transplant2010; 25(1): 225–30.
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AtkarR.K., MacRaeJ.M.. The buttonhole technique for fistula cannulation: pros and cons.Curr Opin Nephrol Hypertens2013; 22(6): 629–36.
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RivaH., DossiC., BonforteG.. Buttonhole: tutto il contrario di quello che ho sempre fatto.Giornale di Techniche Nefrologiche & Dialitiche2013; 25: 89–91.
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LabriolaL., CrottR., DesmetC., AndréG., JadoulM.. Infectious complications following conversion to buttonhole cannulation of native arteriovenous fistulas: a quality improvement report.Am J Kidney Dis2011; 57(3): 442–8.
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Van EpsC.L., JonesM., NgT.. The impact of extended-hours home hemodialysis and buttonhole cannulation technique on hospitalization rates for septic events related to dialysis access.Hemodial Int2010; 14(4): 451–63.
