Cannulation Camp

History of the ButtonholeTechnique• Dr. Twardowski developed the technique in Polandmore than 25 years ago• Dialysis supplies, including AV fistula needles, were verylimited• AV fistula needles were reused for multiple cannulations• The needles became dull after repeated use and wouldnot cut the skin• The “dull” needles would enter smoothly if the exactsame cannulation site was used (same skin entry, sameangle of entry, and same vessel entry depth)• Buttonhole technique was used to successfully solve thedull needle challengeTwardowski Z. Dialysis & Transplantation. 1995;24;559.Peterson P. Nephrol Nurs J. 2002;29:195.Lewis C. Nephrol Nurs J. 2005;32:225.