Buttonhole: The opposite of What I've Always Done

Abstract

The buttonhole technique (BHT) represents an arteriovenous fistula (AVF) puncture tool that allows positioning the needle always at the same site of either the left or right arm of hemodialysis patients. This procedure is more comfortable for patients, and reduces hemostasis time and aneurysmatic degradation of AVF. Despite BHT been rapidly accepted by patients and nurses, some physicians are still sceptical. BHT requires paying particular attention in managing subcutaneous tunnellization and preserve it for each of the next incannulations. Physicians and nurses need continuous training to minimize infective and/or traumatic complications. BHT should be suggested for each hemodialysis patient with puzzling venipuncture.