AV Fistula

AV fistulas are frequently created surgically to facilitate dialysis in patients with severe renal disease. Untreated AV fistulas of significant size might result in serious complications. An AV fistula can be treated more easily if detected early. Additionally, it may help in avoiding formation of blood clots or heart problems.

The method of creating an AV fistula surgery for dialysis access is considered to be low-risk. It is frequently time-sensitive due to the importance of avoiding central venous catheters (CVCs) with their consequences.

These are dural AV fistulas associated with higher venous pressure or vein constriction on the brain’s covering. Increased pressure on veins can cause them to rupture, resulting in intracerebral haemorrhage.

The wound has to be covered for seven days and might take 10 to 14 days to heal completely. The dressing is changed once every three days.

For the next two weeks,performing any hard lifting or applying pressure on the fistula arm must be avoided. Bending the fistula arm for extended periods should be avoided. Dissolvable sutures are the norm for most people. Clips may need to be removed.

After AV fistula surgery, the patient is advised not to wet the dressing for the first two days. The patient can take a bath or shower normally after the dressing is removed. In the case of CVC, it is critical to maintain a dry dressing at all times. The dressing should be covered with plastic  while showering. Taking a bath, swimming or relaxing in a hot tub should be avoided.

• Before and after surgery, wash hands thoroughly with soap and water to avoid touching the AV fistula.
• Keep the skin surrounding the fistula hygienic by washing it frequently with antibacterial soap, particularly before dialysis. Wash and gently pat dry the fistula.
• Strengthen the arm when the wound has healed, as suggested by the doctor.
• Only use it for dialysis.
• See if the fistula region is red or swollen.
• Protect and avoid any harm to the arm.
• Ensure a sufficient diet for optimal health.

Over the next few days, the patient should expect to feel some discomfort and swelling in the area. Keep the arm supported on pillows whenever feasible for the first few days following the access surgery. Keep the arm elevated above the heart level to minimise swelling and discomfort.

Exercise stimulates the flow of blood to the arm. As a result, a needle may be inserted more easily since the fistula has grown stronger. Strengthening the muscles surrounding the fistula provides support to the fistula.

For two weeks, avoid strenuous physical activity. Stop taking prescribed pain medication before driving. As long as the patient doesn’t lift anything heavy, he can resume his normal daily routine.

The pus or blood that drains from the fistula may be noticeable in some cases. This is very common in the days following surgery. For 1–2 days following the surgery, a patient may experience spotting or bleeding. If necessary, place a gauze pad over the fistula opening to absorb the drainage. One to two weeks after surgery, most patients can return to their daily routines and go back to work.

Unfortunately, infection or Fistula might recur even after thorough treatment and healing. If an abscess recurs, it may indicate the presence of a fistula that requires treatment. If the Fistula recurs, more surgery will certainly resolve the issue.