title: Tattoo of vascular cannulation site as a self-cannulation aid.
abstract: BACKGROUND
  Haemodialysis can be provided either in a healthcare setting or home environment. Patients receiving dialysis at home report a better quality of life. Patients or their carers must be able to cannulate their fistula confidently and independently when dialysing at home.
  
  
  METHODS
  We describe a patient with a functional fistula which was difficult to palpate, leading to difficulties in cannulation and multiple referrals to the home therapies team.
  
  
  METHODS
  A series of discrete dots were tattooed to delineate the borders of the fistula and served to guide cannulation.
  
  
  RESULTS
  Following this simple intervention, our patient was able to self-cannulate confidently, dialysing at home four times per week. There were no further referrals to the home therapies team.
  
  
  CONCLUSIONS
  Permanent tattoo of the skin to guide cannulation can used when a fistula is difficult to palpate or if a further superficialisation procedure is not desired. Patients have to be made aware that the markings are permanent and might outlast the fistula.
authors.affiliation: Department of Renal Services, Addenbrooke's Hospital, Cambridge, UK.
authors.forename: Regin
authors.initials: R
authors.lastname: Lagaac
authors.affiliation: Department of Renal Services, Addenbrooke's Hospital, Cambridge, UK.
authors.forename: Rowena
authors.initials: R
authors.lastname: Meruz
authors.affiliation: Department of Surgery, Addenbrooke's Hospital, Cambridge, UK.
authors.forename: Mingzheng Aaron
authors.initials: MA
authors.lastname: Goh
mesh_terms: D001166:Arteriovenous Shunt, Surgical / Q000193:education* / Q000451:nursing*; D002404:Catheterization / Q000451:nursing*; D006437:Hemodialysis, Home / Q000451:nursing*; D006801:Humans; D007676:Kidney Failure, Chronic / Q000451:nursing*; D008297:Male; D010353:Patient Education as Topic; D012648:Self Care; D013653:Tattooing; D062666:Vascular Access Devices
keywords: Haemodialysis; Home therapies; Self-cannulation; Tattoo