Question

Write a 200 word essay on access planning, fistula maturation, common fistula sites, and vessel mapping.

Answer 1

ACCESS PLANNING

Access planning focuses on working with clients to develop strategic and innovative approaches to building vibrant communities and viable projects .It is done from hands on training and capacity building to long term planning ,from strategic advisory services to managing investment projects.Access planning is built on decades of experience working with regions, cities,communities and organizations to pursue innovative and progressive solutions to local planning and development challenges and opportunities. It includes : strategic planning and public policy, structured decision making, advising executives and elected bodies.

FISTULA MATURATION

Fistula maturation is the process by which fistula becomes suitable for cannulation, ie it develops adequate flow, wall thickness,and diameter. pRule of 6s where condition of mature fistula is said :

• minimum 6mm in diameter with clear margin when a tourniquet is in place
• less than 6mm deep
• have blood flow greater than 600mL/min
• be evaluated for non maturation 4-6 weeks after surgical creation if it does not meet above criteria

Maturing fistula should be firm, no longer mushy, vessel wall thickening, absence of prominent collateral veins.

COMMON FISTULA SITES

Fistula is abnormal connection between two hollow spaces.Fistulas are usually caused by injury or surgery, infection or inflammation. Fistulas can develop in various part of body.Common sites are

• carotid cavernous fistula
• preauricular fistula
• atriovenous fistula
• tracheoesophageal fistula
• salivary gland fistula
• gastrojejunocolic fistula
• fistula of appendix
• anal and rectal fistula
• fistula of intestine
• fistula of gallbladder
• fistula of Bile duct
• urethral fistula
• enterovaginal fistula