A New Method That Enables Complete Removal of Scabs at Buttonhole Entry Sites.
BACKGROUND
Scab removal is a time-consuming process and often injures the skin at a buttonhole entry site. Incomplete removal of scabs may cause access-related infection.


METHODS
In a new procedure, buttonhole entry sites were treated with a moist healing step after hemodialysis, and then a formed scab was wiped off with a microfiber towel during bathing on the night prior to hemodialysis, which was performed on the following day. In the moist healing step, the entry site was disinfected with a diluted povidone-iodine solution (0.1% povidone-iodine solution).


RESULTS
When the buttonhole entry sites of the patients were treated with the new procedure, the scabs had already been removed at the buttonhole entry sites, and the sites were covered with a thin transparent membrane. Histological examination showed the thin membrane was stratum corneum, in which nuclei are still seen in keratinocytes.


CONCLUSIONS
By treating the buttonhole entry sites of patients with the wound moist healing method and then rubbing the sites with a microfiber towel during bathing, scabs can be removed without injuring the skin at the sites in advance.
Daiko Medical Engineering Research Institute, Nagoya, Japan.
Takahiro
T
Shinzato
Masatomi
M
Sasaki
Noboru
N
Ota
Kazuhiko
K
Shibata
Hiroyoshi
H
Fukui
Shigeki
S
Toma
Kenji
K
Maeda
D000368:Aged; D000891:Anti-Infective Agents, Local / Q000627:therapeutic use*; D001166:Arteriovenous Shunt, Surgical; D001494:Baths / Q000379:methods; D002406:Catheterization, Peripheral / Q000379:methods*; D005260:Female; D006801:Humans; D015603:Keratinocytes / Q000473:pathology*; D007676:Kidney Failure, Chronic / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D011206:Povidone-Iodine / Q000627:therapeutic use*; D006435:Renal Dialysis / Q000379:methods*; D012867:Skin / Q000473:pathology*; D014945:Wound Healing
D000891:Anti-Infective Agents, Local; D011206:Povidone-Iodine