What to Expect After Peritoneal Access Surgery
You have just had a peritoneal dialysis (PD) catheter placed in your
abdomen. In the next few weeks, you will be working with a peritoneal
dialysis nurse to learn how to manage your PD on your own.
The area around your catheter needs time to heal, so please take care not
to put strain on the area or disturb the dressing.
Feeling some pain around the site and noticing a small amount of draining
on your dressing is normal. If the dressing is soaked with blood, or if you
see thick, yellow discharge on the dressing (pus), please call your PD or
dialysis access nurse coordinator.
What to Expect After Hemodialysis Permacath Access Surgery
You have just had a hemodialysis catheter, or "permacath" placed. One end
of the catheter is in a vein in your neck, the other end is in your chest.
You will have two dressings: one over the small incision in your neck,
another on the catheter in your chest.
Some pain, slight bruising, and swelling are normal on both your chest and
neck. Also, a small amount of drainage on your dressings is normal.
Please call your dialysis access nurse coordinator if:
Pain, bruising or swelling gets worse over the next few days
Dressing is soaked with blood, or if you see thick yellow drainage
(pus) on a dressing
What to Expect After Hemodialysis Fistula or Graft Access Surgery
You have just had surgery to place an Arteriovenous (AV) fistula or shunt
by directly sewing an artery to a vein in your arm. Or, if fistula access
was not feasible, you have had an AV graft placed in your elbow or armpit.
Both procedures create an access for the needles that will be used in your
A surgeon creates an AV fistula by connecting an artery directly to a vein,
usually in the forearm. Connecting the artery to the vein causes more blood
to flow into the vein. Over time, (in some cases as much as 2 years) the
vein grows larger and stronger, making repeated insertions for hemodialysis
If you have small veins that won't develop properly into a fistula, you can
get a vascular access that uses a synthetic tube implanted under the skin
in your arm. The tube becomes an artificial vein that can be used
repeatedly for needle placement and blood access during hemodialysis. A
graft does not need to develop as a fistula does, so it can be used sooner
after placement, often within 2 or 3 weeks.
What to Expect After Access Surgery
It is normal to experience some pain and swelling over the next several
days. For the first few days after your access surgery, keep your arm
elevated on pillows whenever possible. Be sure to keep your arm above the
level of your heart to control swelling and ease any discomfort you may be
Your arm may bruise slightly. It is normal to see some blood oozing through
the dressing. If blood is soaking the dressing or if you see thick, yellow
drainage on the dressing, please contact your dialysis access nurse
You can expect to feel a "buzzing" sensation through the bandage. The
buzzing is normal and means that the access is working and blood is flowing
through it. This sensation will increase over the next several days.
You should be able to move your hand normally. Your sense of touch in your
hand should be normal as well. If you cannot move or feel things in your
hand normally, please contact you dialysis access nurse coordinator.
The appearance and general feeling of your hand on the access side should
be normal. If your hand becomes pale, blue, or turns cold, please contact
your dialysis access nurse coordinator.
Regardless of which type of access surgery you have had, your doctor will
discharge you with a prescription for pain medication. Please take as
directed. The medicine should ease the soreness at the access site,
although you can expect to feel some discomfort over the next few days. If
pain at the site becomes severe or does not get better when you take the
medicine, please contact your dialysis access nurse coordinator.
The pain medication may cause constipation. Talk with your own doctor about
whether you need to take a stool softener or mild laxative.
We recommend that you do not take the prescription pain medication for
longer than three days. If you feel you need pain medicine for longer than
three days, please contact your dialysis access nurse coordinator.
If you were taking blood thinners such as aspirin or warfarin (Coumadin)
before surgery, please talk with your doctor about when to resume this
medication. You should go back to taking any other medicines you were on