Open technique has lower evidence of complications

BMJ 1995;311:1090 (21 October)

Letters

Open technique has lower evidence of complications

EDITOR,--We disagree with Andy Adam's comments regarding thedrawbacks of an open surgical technique for placing long termcentral venous catheters. It is our practice to place such cathetersby using an open cutdown technique under local anaesthesia.We mainly use the cephalic vein, with fluoroscopic screeningto ensure correct positioning. With this technique more than800 catheters have been inserted over the past 10 years, forparenteral nutrition, antibiotics, and chemotherapy. The incidenceof pneumothorax and injury to vessels at the root of the neckhas been zero. These types of complications are seen when blindpuncture techniques are used and were one reason for our changeto an open technique. The bulk of our practice is the treatmentof very sick patients with intestinal failure, who would toleratesuch complications badly. Using our method, over the past 12months we have failed to achieve central venous access in . . . [Full text of this article]

Add to CiteULike CiteULike Add to Complore Complore Add to Connotea Connotea Add to Del.icio.us Del.icio.us Add to Digg Digg Add to Reddit Reddit Add to Technorati Technorati What's this?