EVALUATION OF THE EFFICACY OF THE BUTTONHOLE TECHNIQUE IN MAINTENANCE HEMODIALYSIS PATIENTS WITH AUTOGENOUS ARTERIOVENOUS FISTULAS AT HUNG VUONG GENERAL HOSPITAL, PHU THO PROVINCE, IN 2025
Main Article Content
Abstract
Background: The Buttonhole technique is an alternative method to conventional sharp needle cannulation into the functional vascular access segment in hemodialysis patients. Although implemented in several medical facilities in Vietnam, no published studies have evaluated its efficacy.
Objective: Operational definitions were established for local infection, needle-site bleeding, and hemostasis time.
Subjects and Methods: A cross-sectional analytical study was conducted on maintenance hemodialysis patients at the Hemodialysis Unit, Hung Vuong General Hospital, Phu Tho. Inclusion criteria: patients undergoing hemodialysis via a well-functioning arteriovenous fistula (AVF), willing to participate, and capable of reading and answering questionnaires (n = 82, including 56 patients using the Buttonhole technique and 26 patients receiving conventional sharp needle cannulation).
Results: Pain levels in the sharp needle group across three evaluation points (cannulation, during dialysis, and needle withdrawal) were significantly higher than those in the dull/blunt needle group. Specifically, during cannulation, patients in the sharp needle group experienced a median pain score of 5 (IQR, min/max: 2; 3/8), whereas the dull needle group reported a median score of only 1 (IQR, min/max: 2; 0/4). Regarding hemostasis, the dull needle group achieved faster post-withdrawal hemostasis than the sharp needle group, with 77% achieving hemostasis in under 30 minutes. Furthermore, the rate of post-cannulation bleeding/oozing at the puncture site was higher in the sharp needle group (81% vs. 54%).
Conclusion: The Buttonhole technique is effective in reducing pain during needle insertion, shortening post-withdrawal hemostasis time, and lowering the rate of oozing at the puncture site.
Keywords
Buttonhole technique, dull needle, blunt needle, Buttonhole efficacy, evaluation of dull needle efficacy
Article Details
References
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