Aim: The type of skin incision utilized in arteriovenous (AV) fistula creation may significantly influence the patency, maturation, and overall outcomes of the fistulas. An oblique skin incision may offer distinct advantages in preventing early AV fistula failure by reducing skin tension and minimizing pressure on the newly formed anastomosis. This study aims to compare the postoperative early period outcomes of oblique versus straight skin incision techniques, with a focus on their impact on AV fistula success.
Material and Methods: 2020 to 2023, all patients with created AV fistula via distal antebrachial vessels with oblique and straight skin incisions were enrolled. Retrospectively, the patients’ demographics, comorbidities were collated from the hospital data. All patients were operated with local anesthesia for radiocephalic AV fistula creation. The characteristics of the vessels were determined through preoperative Doppler ultrasonography mapping. Evaluations were conducted on primary patency, early maturation, and the incidence of early thrombosis.
Results: In Total, 182 patients were operated for AV fistula creation. The mean age was 57±17 years and there was a male predominance with %68. We performed 74 patients AVF creation via straight skin incision and 108 via oblique skin incision. Despite there being no differences in comorbidities and demographic characteristics between the two groups, the group with a straight skin incision exhibited a higher incidence of early thrombosis (p=0.03), a lower maturation rate (p=0.03), and reduced primary patency (p=0.01).
Conclusion: Oblique skin incision could be a feasible alternative to conventional straight incision with a higher early AVF patency and lower thrombosis rates. Reducing the pressure on and keeping the incision away from the new anastomosis may be crucial for achieving better outcomes.
Key words: Arteriovenous fistula, incision type, maturation
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