Found the answerer to infections in buttonholes

Ask Our Experts Stuart Mott, Cannulation Expert
1

It has come to my attention over tne last several years that my ANNJ article “A Kinder Gentler Way to clean Buttonhole Sites “ Sept-Oct 2011 needs a update. Over the last three years plus i have had multiple home dialysis patients contacted me about their scab removal on their button access site using tne the scrubber technique which they all claim that it help them out. But I have been informed by the university of Vermont had out by Peggy Bushey BSN RN, CDN, AdamLlocke CCHT, Donna Spaeth BSN RN,CDN, Cynthia LaCroix RN, CNN Macaulay Onuigbo, MD MSc MBA FWACP FASN that they have using the following:
1.Wash access site with ant-bacterial soap and dry with a paper towel. Witch I describe in my article
2. Moisten a sterile 2X2 with sterile saline and a good drop of ant-bacterial soap { which I also recommended the soap} on each buttonhole site
3.Genteral rub the sterile 2x2 over the buttonhole site to aid in penetration of soap { which I completely agree with} and leave in place for a min of 15 minutes ( time varies by patients need to soften up the scab.
4. Remove the 2x2 and rinse tap with water.( this is the only disagreement I have you don’t know what is the water)
5.New sterile 2X2 are used to rub off the scab (this is usually very soft and comes off easily.(I used the scrubber but the same idea)

The scab should never be pick off

In conclusion we that is my patients in center at home and I over the last 10 years have gone over 66,000 scrubber cleaning no infections. It would be interesting that the university of Vermont are anyone else report their numbers, and they just did 04/20/2021 they have NOT HAD A INFECTION Related BSI in over 922 days.

2

I would be interested to hear from other experts/access professionals. Particularly those in the UK
As a long term ‘expert’ patient, my own biggest drop in infection rates has been mask wearing during cannulation. (infection = 0)

Pickers, on ‘blunt’ needles are offered to some patients.

3

My son first wipes button holes with alcohol pads then uses sterile gauze pads that he puts saline on to soak his button holes for approximately 10 minutes.
He then uses the scraper that comes with the blunt needle to remove scabs.
Should he be using antibacterial soap prior to removing scabs?
Any recommendations or a better way or letting us know if what he’s doing is ok would be appreciated.
Thank you

4

Why should the scabs never be scraped or picked off ?
My son uses the picker that is on the blunt needles for his button holes

5

In my articles over the last ten years infection in buttonhole is the main reason that many country’s have stop using them. The university of Vermont and i have found that soaking them off is the best method to prevent infections. We have gone over 100,000 with out a single infection. If you what your son to continue scraping off his scabs that up to you. But understand there is know a safer way to do it. Any questions call me at 573-826-8237

6

uyes by all means use a antibacterial soap

7

do you live in the UK?

8

because it leaves a torn tunnel track that levees it open to infection