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Revista de la Sociedad Española de Enfermería Nefrológica

Print version ISSN 1139-1375


GRAU PUEYO, Carmen et al. Vascular access puncture in haemodialysis is a necessity. The buttonhole method is an option. Rev Soc Esp Enferm Nefrol [online]. 2011, vol.14, n.1, pp.30-36. ISSN 1139-1375.

Introduction: The access puncture technique, as well as affecting survival, is a cause for anxiety and discomfort for the patient. There are three puncture techniques: rope-ladder, area and buttonhole. Studies carried out on this last method associate it to a reduction in pain and the complications associated to puncture. Aim: To introduce the buttonhole puncture method in our Unit. Methodology: Observational descriptive study, carried out at our haemodialysis unit. All the patients on haemodialysis with a healthy and non-prosthetic arteriovenous fistula were included in this study. The sample will be 35 randomized patients with a monitoring period of 6 months. Prior to commencing the study, nursing staff were trained in the technique and a specific puncture protocol was created. All the variables to be analysed are recorded at each haemodialysis session. Descriptive statistics is applied for the Student t variable for the difference between means and x2 and Fisher's exact test for the proportions, where p<0.05 is considered significant. Kaplan-Meier survival analysis. SPSS 14.0. statistical package. Results: The sensation of pain during puncture and bleeding time were reduced significantly in all patients. No complications occurred during the study period. Conclusions: The buttonhole puncture technique reduces the pain perceived by the patient, giving greater satisfaction. The buttonhole puncture technique is a good alternative for accesses that are not well developed or have puncture problems, favouring self-puncture and home haemodialysis options.

Keywords : Vascular Access; Pain; Puncture.

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