Relationship between Years Elapsed after Initial Buttonhole Cannulation and Frequency of Vascular Access-Related Infections.

Abstract

A reason for the higher frequency of vascular access-related infections in buttonhole cannulation patients remains to be elucidated. If the higher frequency of infections is associated with a factor(s) inherent to the buttonhole method (e.g. existence of a buttonhole track or other factors), the frequency of such infections is expected to increase upon starting buttonhole cannulation. On the other hand, if the higher frequency of the infections is associated with a factor(s) developing secondarily while performing buttonhole cannulation for months or years (e.g. deformity of the buttonhole entry site or other factors), the frequency is expected to rise after a certain time elapses from initiation of buttonhole cannulation. In case the higher frequency of the infections is associated with a factor(s) developing secondarily, the problem may potentially be solved. Thus, the present study is to clarify whether there is 'an infection calm period' after buttonhole cannulation is started. The relationship between the time (in years) after buttonhole cannulation is started and frequency of vascular access-related infections was investigated. Frequency of access-related infections was almost constant for 6 years after buttonhole cannulation was started. At the sixth year from initiation of buttonhole cannulation, however, the frequency of access-related infections started rising. The rise in frequency of vascular access-related infections in buttonhole cannulation may not be directly associated with inherent factor(s) of the method, but rather a factor(s) developing secondarily while performing buttonhole cannulation over a period of years.