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Started in July 2009 with two patients has grown over the years to 38 patients and others that are unknown., Now with over 25,000 buttonhole cannualtion with out a infection this method appears to be the way to. clean buttonholes. nephrology Nursing journal Sept-Oct 2010 P439-443

The needles we use have a white plastic "steri-pick" in the end of the needle cap. It's designed so you can pull it out to use without removing the cap from the needle itself. That way both are sterile when you begin to use them. Obviously all the standard washing and disinfection is used per protocol prior to even removing the steri-pick, as well as disinfection after the scab is removed since a scab is a breeding ground for bacteria!!!
Here is a link to show you what I'm talking about. http://www.nxstage.com/medisystems/products/buttonhole-with-steripick