MIDDLESEX SURGICAL ASSOCIATES, INC.
955 MAIN STREET, SUITE G2A
WINCHESTER, MA 01890
VOICE: 781-729-2020
FAX: 781-729-6846
INSTRUCTIONS AFTER YOUR SURGERY FOR
HEMO DIALYSIS ACCESS
AFFILIATED WITH TUFTS UNIVERSITY
SCHOOL OF MEDICINE
WILLIAM L. BRECKWOLDT, M.D., F.A.C.S.
KELLEY M. CORNELL, M.D., F.A.C.S.
PATRICK F. BROPHY, M.D., F.A.C.S.
MARTA QUIJANO, M.D.
NAYOMI EDIRISINGHE, M.D., F.A.C.S.
LIMARIS BARRIOS, M.D., F.A.C.S.
KATHLEEN SLOPER, A.N.P.
Date:
Surgeon:
Nephrologist (Kidney Doctor):
Your fistula is a connection made between your
____________________________ and ____________________________
using ____________________________.
1. If you had a fistula made out of a vein, it may take twelve or more weeks
before the fistula is ready for use for dialysis. If you need dialysis sooner,
you may need a temporary catheter in the neck until the arm vein is large
enough and strong enough (matured).
2. If you have had a graft, it may take two or more weeks for the graft to
heal into the surrounding tissues before it is ready to use for dialysis. If
you need dialysis sooner, you may need a temporary catheter in the neck
until the graft is ready to be used. Your nephrologist will tell you when
you need to start dialysis.
3. Your arm will tend to get swollen, yet if you keep your arm elevated after
surgery as much as possible for the first week or two, this can reduce the
amount of swelling. Bruising is also common. If the swelling and bruising
are increasing you should check with your surgeon. If you have any active
bleeding you should apply gentle direct finger pressure and check with
your surgeon.
4. You should feel your graft every morning before getting out of bed to be
sure there is a thrill (the vibration you can feel when the blood is going
through the fistula), and also at night before going to bed. If you are
unable to feel the thrill DO NOT eat or drink anything and call our
office right away (781-729-2020).
5. You can expect your hand to feel cooler, but you should call your surgeon
if there is any numbness, pain or difficulty moving your fingers.
6. If you have a clear plastic bandage on your arm, you should keep this on
for at least two weeks, or until you have seen your surgeon. If you have
any signs of infection (redness, warmth, fever over 101 ˚F, swelling or
increase in tenderness) please call our office at 781-729-2020.
7. Care should be taken that you do not carry heavy items with the arm that
has the fistula/graft. Do sleep on your side with the fistula. Do not allow
blood pressure to be taken or blood to be drawn from the arm with the
fistula. Do not wear any tight clothing or jewelry over the fistula/graft.
8. When you get home call our office (781-729-2020) for an appointment in
2 weeks.