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Arterio-Venous Fistula Creation Post-Surgery Instructions

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​​What is an Arterio-Venous Fistula Creation?

An arterio-venous fistula is a type of dialysis access which requires the creation of an artificial connection between an artery (which carries blood away from the heart) and a vein (which carries blood back to the heart). This allows the vein to be enlarged and the vein walls to be thickened, so that adequate blood flow can be delivered during hemodialysis treatment.

After the procedure, maturation of a fistula may take weeks or months before it can be used for hemodialysis treatment.

What Should I Take Note of After the Procedure?

The following instructions provide general information and advice regarding care after the procedure. Taking these precautions may help to reduce risks and complications.

Wound Care

  • Please ensure the dressing is kept dry. The dressing should be changed once it is dirty or blood-stained.
  • In some cases, the skin stitches used are absorbable and do not need to be removed. Otherwise, you will be given an appointment date if your stitches require removal. If in doubt, check with the medical team prior to discharge. Once the stitches are removed, the fistula arm can be washed with soap and water.
  • Do not use the fistula arm to lift heavy weights for at least two weeks post-surgery.
  • After one week post-surgery, exercise the hand with a rubber ball several times a day for a few minutes. This will promote maturation of the fistula.
  • After two weeks post-surgery, usual daily activities can be performed. Using the affected arm will improve the blood circulation to the fingers and will also prevent the arm from becoming stiff.

Pain Management

  • Take your medications as prescribed.


  • Resume your renal diet.

What Special Instructions Should I Take Note of?

  • Ensure that blood circulation in the arm should not be cut off once fistula is placed, as this may damage the fistula and cause it to stop working.
  • Check your fistula for a buzz/thrill several times a day.
  • Ensure the fistula arm is kept warm, especially in cold weather.
  • Avoid direct impact on the fistula.
  • Avoid sleeping with your weight pressed on the fistula arm.
  • Do not allow blood pressure to be taken using the fistula arm.
  • Do not allow blood to be taken from the fistula arm.
  • Do not wear tight sleeves, or cuffs above or below the fistula arm.
  • Do not wear a watch on the fistula arm.
  • Do not expose the fistula to sharp equipment or hazardous machinery.

When Should I Seek Medical Attention?

You should seek medical attention if you experience the following:

  • The fistula stops buzzing / there is an absence of thrill
  • The appearance of the fistula alters dramatically, e.g. becomes a large lump
  • Pain or tingling in the hand
  • Chills and a fever of 38 degrees Celsius and above
  • Signs of infection such as swelling, redness and discharge seen from the fistula site
  • The fingers become cold and appear bluish

Arterio-Venous Fistula Creation Post-Surgery Instructions 1.png Arterio-Venous Fistula Creation Post-Surgery Instructions 2.png

Where Can I Seek Medical Attention?

During office hours: Contact the Renal Unit staff at 63571366 (during Weekdays office hours).

After office hours, Saturdays/Sundays & Public Holidays: Head to Emergency Department.

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