The buttonhole technique: strategies to reduce infections.

The buttonhole technique has gained popularity over the last decade in the United States. The fact that it is a relatively new technique, which requires a change to current cannulation practice, has contributed to several unforeseen complications that have led to increased infection rates in AV fistulae. To keep this technique a viable option for patients, it will be necessary to understand the potential infection risks and implement strategies to reduce the incidence of infection.