graft vs fistula

[kell1566]

hey guys i wanted to see if the experts could help me wiht this.....i get on the inside the difference with the fusing vs graft; but can u tell the difference on the outisde by lookin at the skin....it seems like they all look the same? is there a way to distinguish if the pt wasnt sure which they had done? thanks

[Hellllllo Nurse, BSN, RN]

A graft is usually in a horse-shoe or letter C shape, and is normally firmer to the touch. Fistulas usually run up and down and are more squiggly shaped, with bumps (pseudo anurisms) and softer to the touch.

Here are some good pics of fistulas. For some reason, I could not find any pics of grafts on the net. Grafts are usually much smoother and more even than fistulas.

[DeLana_RN, BSN, RN]

Agree with pp, just wanted to add that it is sometimes not easy to tell the two types of peripheral accesses apart, especially with upper arm grafts (AVGs) or fistulas (AVFs). Some grafts and fistulas in that area are very deep and therefore not easily assessed (or cannulated); plus, AVGs can also have pseudoaneurysms.

Good question, though; as you have found out, some pts are not reliable in reporting the type of access they have any some don't even know. Just don't call it a shunt (an archaic term for a type of external access that was used in the past that I still hear some doctors use!)

DeLana