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Closed Sleeve Bandage to Protect Dialysis Shunts

Steven A. Schwid, MD; Willem J. Kolff, MD
JAMA. 1967;202(2):156. doi:10.1001/jama.1967.03130150124042.
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To the Editor:—  Persons sustained by maintenance hemodialysis must protect their arteriovenous shunts to save their lives. A protective dressing is necessary to avoid trauma, infection, and hemorrhage. The patient must be able to manipulate the bandage, often with one hand only, so that he can carry on routine daily care of the shunt without assistance. A good protective device increases a patient's self-sufficiency, confidence, and safety.We recently have employed the protective device illustrated in the accompanying figures. It is constructed from a single piece of 6inch wide rubberized cotton bandage tapered to fit the patient's arm or leg and fastened with a single strip of 1-inch wide nylon hook and burred fabric closing (Fig 1). The closure allows sufficient leeway so that the bandage may be snugly applied over varying thicknesses of sterile dressings (Fig 2). It also provides proper fit despite the slight stretching of the elastic


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