title: SHARP VERSUS BLUNT DIALYSIS NEEDLE USE WITH BUTTONHOLE METHOD: OPEN RANDOMISED TRIAL.
abstract: BACKGROUND
  Current protocols recommend the use of a blunt needle to access the arteriovenous fistula via a buttonhole. This study aims to demonstrate whether a sharp needle can be used at the same buttonhole site without causing complications.
  
  
  OBJECTIVE
  To measure and compare fistula cannulation failures between the use of blunt and sharp needles. PLAN: Open-crossover randomised controlled trial.
  
  
  METHODS
  Adult out-patients who had provided consent and were on dialysis with a mature arteriovenous fistula and buttonhole cannulation.
  
  
  METHODS
  Failed cannulation-difficulty in inserting the needle and the trampoline effect; incidence of complications, such as infection and haematomas; times to haemostasis; patients' pain; and patients' preferences.
  
  
  RESULTS
  Based on analysis of the data from the 35 patients enrolled, no significant differences were detected in failed cannulation of the fistulae between the use of a blunt needle and a sharp needle for the 335 venous accesses (p = 0.071). However, a significant difference was detected for the 335 arterial accesses (p = 0.001), in which the sharp needle was more effective. Significant differences were also detected in the difficulty of insertion and in the trampoline effect for both venous and arterial access (p < 0.05); the use of a sharp needle was more favourable.
  
  
  CONCLUSIONS
  This study demonstrates an increased incidence of failed cannulation using a blunt needle compared with using a sharp needle, although this was not significant. In addition, the use of a sharp needle did not result in any increase in complications.
authors.affiliation: Dialysis Centre Ospedale Bellaria, Azienda Unità Sanitaria Locale of Bologna, Bologna, Italy.
authors.forename: Claudio
authors.initials: C
authors.lastname: Morselli
authors.affiliation: Department of Medical and Surgical Sciences, University of Bologna, Bologna, Italy.
authors.forename: Paolo
authors.initials: P
authors.lastname: Chiari
authors.affiliation: Dialysis Centre Ospedale Bellaria, Azienda Unità Sanitaria Locale of Bologna, Bologna, Italy.
authors.forename: Tiziana
authors.initials: T
authors.lastname: Aliberti
authors.affiliation: Master's Degree Course in Nursing Sciences, University of Bologna, Bologna, Italy.
authors.forename: Guglielmo
authors.initials: G
authors.lastname: Celli
authors.affiliation: Dialysis Centre Ospedale Bellaria, Azienda Unità Sanitaria Locale of Bologna, Bologna, Italy.
authors.forename: Silvia
authors.initials: S
authors.lastname: Catalani
authors.affiliation: Dialysis Centre Ospedale Bellaria, Azienda Unità Sanitaria Locale of Bologna, Bologna, Italy.
authors.forename: Ignazia
authors.initials: I
authors.lastname: Miale
authors.affiliation: Dialysis Centre Ospedale Bellaria, Azienda Unità Sanitaria Locale of Bologna, Bologna, Italy.
authors.forename: Vanessa
authors.initials: V
authors.lastname: Melandri
authors.affiliation: Dialysis Centre Ospedale Bellaria, Azienda Unità Sanitaria Locale of Bologna, Bologna, Italy.
authors.forename: Lorenza
authors.initials: L
authors.lastname: Bianchi
mesh_terms: D000328:Adult; D001166:Arteriovenous Shunt, Surgical / Q000379:methods*; D002404:Catheterization / Q000379:methods*; D018592:Cross-Over Studies; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009339:Needles; D010045:Outpatients; D006435:Renal Dialysis / Q000295:instrumentation*
keywords: Arteriovenous fistula; Buttonhole technique; Cannulation; Haemodialysis