Buttonhole: What Makes the Difference

Abstract

In the last 10 years a great number of contributions have been published on the buttonhole (BH) cannulation technique, mainly by nurses. The word “buttonholing” has gained popularity in the dialysis settings. All studies tried to explore the announced attracting outcomes of this technique: minor pain, less aneurisms, less AVF complications, and easier cannulation for both nurses and patients. Data have been collected for all these areas either as single topic or in multiple-topic data collection analysis, in different settings, with different sample sizes and different observational times. Thanks to this “realistic” approach the challenge of infection could be detected and managed. The variation in the incidence of infections had very low statistical impact, but was relevant for the caring team. What was cited as a “rare alert” by BH founders showed to be, in fact, a real possibility. The present article will refer to the most recent studies, all the variables included, and the related outcomes, and will then try to highlight the issues, related to nursing care, which correlate with positive outcomes of BH performance in hemodialysis patients.