The Buttonhole Technique of Fistula Access: A Personal Experience

Iam a 16-year home hemodialysis patient using the buttonhole method of needle insertion into my arteriovenous fistula. From the beginning of my home training I was taught to stick myself. Like most patients, I was taught to rotate needle sites up and down my arm. I used this method for 10 years. In 1990, I learned about the buttonhole technique; I started using it and am still using it today with great success. In this method needles are inserted in the exact same holes. There is no pain with this technique, and there is a great sense of confidence in having fixed, well-known sites; I am certain to have a successful stick almost every time. The buttonhole technique practically eliminated infiltrations. Since I see no reason why the buttonhole sites cannot be used on a daily basis, I am looking forward to using the technique when daily hemodialysis becomes available.