Venous cutdown

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Venous cutdown is an emergency procedure to get vascular access, in which the vein is exposed surgically and then a cannula is inserted into the vein under direct vision. It is used in trauma and hypovolemic shock, when peripheral cannulation is difficult or impossible. The saphenous vein is commonly used, but antecubital and femoral vessels are also suitable. Complications of venous cutdown include cellulitis, hematoma, phlebitis, perforation of the posterior wall of the vein, venous thrombosis and nerve and arterial transection.