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Kelly-Wick tunneler sets are used for the precise subcutaneous tunneling that is mandatory for hemodialysis blood access grafts. Developed specifically for access grafts, Kelly-Wick tunnelers are designed to minimize trauma, allow accurate depth control and create a uniform circular tract slightly smaller than the outer diameter of the graft.

Design

  • The KW2000 is designed for hemodialysis blood access grafts.
  • Each 6 mm diameter shaft has a knurled handle that facilitates positive directional guidance and depth control.
  • Blunt design of the interchangeable threaded tips separates, rather than cuts tissue, thereby minimizing tissue trauma.
  • Each tip features a suture hole to aid in securing the graft and a machined waist to make a smooth transition on to the shaft.

Tunneling Technique

  • The tunneling technique used influences the performance of vascular grafts, especially in the early postoperative period.1
  • Long grafts should be placed without kinking or twisting.
  • Hemodialysis grafts must be placed superficially enough to allow easy cannulation, yet deep enough to prevent skin erosion, especially in the diabetic patient.
  • The use of clamps, forceps, surgeon’s fingers, trocars and sheaths may cause excessive tissue trauma, leading to perigraft swelling, seroma or even hemorrhage.2 Any one of these can compromise patency, delay healing and prevent the safe early use of blood access grafts for hemodialysis.

References

1. Taucher, L.A., M.D. Immediate Safe Hemodialysis into Arteriovenous Fistulas Created with a New Tunneler: An Eleven Year Experience. The American Journal of Surgery 1985; 150.2: 212-15.
2. Haag, B.W., M.D. Early Use of Polytetrafluoroethelyene Grafts for Hemodialysis Access. Vascular Access for Hemodialysis II. Bruce G. Summer, Mitchell L. Henery, W.L. Gore and Associates Precept Press, Inc., 1991: 173-177.



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