Arteriovenous Fistula(av fistula procedure) is the surgical procedure in which the anastomosis of the artery and vein. The main aim of creating av fistula for continuous flow in the mainstream of the blood flow and av fistula for dialysis
The fistula is created prior to surgical or for the Dialysis purpose
Indication
Chronic kidney disease
Preparation for Renal Dialysis
Kidney Failure
Before AV Fistula Procedure
- Prepare the heparin saline dosage is confirmed by the surgeons
- Surgical eye loupes-for surgeons
- Make sure the no iv fluid or fluid is given to the patient.
Creating av fistula needs surgical loupes for fine suturing and handling.
Disposable Items
1.Blade 15 size & Blade 11 size
2.syringe 20 ml 2 nos
3.Iv cannulae three different sizes pink 20G, yellow 22G/blue 24G and green 18 G 1 each
Note: remove the needle and use the only catheter from the iv cannulae
4.Vessel Loops 2 nos (If arteriovenous grafting is done take a separate drape after the dissection is done, When ready for grafting.)
| General instruments
BP handle 7 sizes or 3 sizes. Adson fine forceps both toothed and non-toothed Bowl, kidney tray. Retractors -cat’s paw. Fine scissor (Kilner scissors), straight scissors fine –for suture cutting. Needle holder
|
Micro instruments
Fine forceps –jewel forceps curved microscissors, Micro suture cutting scissors – Straight Vanas scissor Microneedle holder
Note: take a separate the lint piece for the micro-instruments for arranging on the trolley. |
Arteriovenous Fistula – Vascular instruments
Medium /small size vascular clamps ( DeBakey/Satinsky)
DeBakey fine vascular forceps
Bulldogs -straight and curved
Suture
Fine suture Prolene 5-0 or 6-0 that surgeons preference
Surgical loops
[i]Note by https://surgicaltechie.com/
AV Fistula Care
Arteriovenous fistula procedure used for dialysis procedure. After the surgery patients advised to elevate the hand at the chest level for a better outcome.
av fistula for dialysis will work only a few days according to age groups and patients conditions.
Do the Stree ball exercise for good results
Special care dressing and stitches will save the fistula life
Do not lift any heavy weight on the operated hand
Avoid water spillage on the dressing to avoid infections
The Proper following of Surgeon medication and Hand exercise by a physiotherapist will help the patients in a good outcome.