AV Fistula / Graft Post-Operative Instructions

  • A post-operative visit may have been arranged as noted in your paperwork. You may call the office during business hours to verify your post-operative visit date and time if needed. Office hours are 8am-12pm and 2pm-5pm Monday through Thursday and 8am-12pm on Friday.  
  • You have likely had a nerve block for anesthesia.  Your arm may be numb and/or partial paralyzed for a few hours after you leave the hospital.  You will be provided an arm sling.  This is for comfort measures until you have your strength back in your arm.  You do NOT need to use the sling after you can fully move your arm.  
  • If you are on dialysis at the time of surgery, please show the dialysis nurses your fistula or graft so they can evaluate it for flow with each hemodialysis session. 
  • You should exercise your hand and forearm with an exercise/stress ball or a rolled-up pair of socks or washcloth beginning the evening of surgery.  This can be performed several times throughout the day.  You can’t exercise too much.  If you are watching TV, squeeze the ball 20 times every time a commercial comes on.  
  • It is normal to have some swelling in your arm after surgery (especially after AV graft placement).  This tends to get worse after the 3rd to 5th postoperative days.  This is NORMAL.  It will go down slowly over the next couple of weeks.  Sleep with your arm elevated and continue with arm and hand exercises.  
  • Your incisions may be closed with absorbable sutures, and if so, they will be covered with Dermabond, which serves as a waterproof dressing.  You can shower or bathe the day after surgery, but do not submerge the incisions under water for 14 days.
  • Your incisions may be closed with staples. If present, there will be a gauze dressing over the staples. If you have a standard dressing, it may be removed 24 hours after your surgery, unless otherwise instructed. It may be replaced as needed for protection of the underlying staples with a similar dry gauze dressing.  You can shower or bathe the day after surgery, but keep the incisions and dressings as dry as possible.  
  • Prescription pain medication may cause nausea and will often cause constipation.  You may take an over the counter laxative as needed. 
  • The on-call physician will not be able to provide narcotic pain medication. By law, narcotic pain medication cannot be called in to a pharmacy. 
  • Notify us for fever over 101, or go to the nearest ER immediately for significant shortness of breath.  
  • Driving after surgery is not recommended until prescription pain medication is no longer needed. You may typically drive if narcotic pain medication has not been taken within 24 hours.
  • Some redness around the incision is expected and does not require antibiotics; however, if the redness significantly expands in size or if a surgical site becomes increasingly tender, please call for further instruction. 
  • Do not take Tylenol (acetaminophen) within 4 hours of taking a narcotic pain medication.
  • An on-call physician is available at all times for emergencies; however, we ask that you call during business hours for non-emergent and routine questions.  

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