The formation of an arteriovenous fistual for dialysis by routine interrupted sutures anastomosing the vein and artery is difficult to perform and time-consuming. A new method, telescopic adhesive anastomosis was studied and applied in 10 hemodialysis patients, who were in need of an arteriovenous fistula. The external diameter of the vessels anastomosed was 2.40 +/- 0.20 mm (radial artery) or 2.40 +/- 0.35 mm (cephalic vein). After thorough debridement of the vascular ends, the arterial end was put in the venous lumen. In order to fix the telescopic vessels, two stitches were applied 180 degrees apart from each other and tied. Each stitch was inserted from vein (penetrating the whole wall) to artery (just through the adventitia and partial thickness of the media vasorum). The distance from the stitch to the edge of the vein was 0.5 mm, and that of the artery was approximated to the external diameter of the vessle. The medical adhesive was then applied for sealing the anastomotic adventitia. Ten seconds were given for the solidification of the adhesive. The patients were followed up for 8 months. The patency rate was 100%, and the rate of blood flow was more than 300 ml/min (measured by ultrasonography). It was shown that this method could be managed easily and quickly, and the so-formed fistula would fulfill the need of hemodialysis.
ObjectiveTo investigate the incidence of medical adhesive-related skin injuries (MARSI) and analyze its influencing factors among elderly patients, in order to provide reference for its prevention. MethodWe carried out a cross-sectional descriptive study in the Department of Geriatrics of a class-3 grade A hospitals in Sichuan Province between June 1 and July 31, 2015. Totally, 288 patients aged from 62 to 95 years [with the average of (82±13) years] met the inclusion criteria of the study. We analyzed the MARSI situation of the patients, and at the same time, we surveyed 126 nursing workers on their knowledge about MARSI. ResultsThe number of patients with MARSI was 37, and the incidence was 12.85%. The difference of Braden scores between patients with and without MARSI was statistically significant (P<0.001) . About 70% of the nursing staff knew little about MARSI. ConclusionsWe should pay attention to MARSI, improve nurses' knowledge and explore scientific preventive measures.