All invasive procedures carry some degree of risk of damage to the normal structures in the proximity of the region where the procedure is performed.1
Both percutaneous (venepuncture) and cut down (venesection) techniques have been routinely employed on the patients with varying complications; however, the cut down procedure has been reported to be comparatively safe.2,3
The majority of the complications related to nerves have been attributed to the injury to the cutaneous nerves resulting from the blind access of the venepuncture.1,4,5
, in a retrospective study on implantable venous devices, have reported the rate of complications of cephalic vein cut down as 11%.2
There is only one isolated case in the literature, reported in 1989, mentioning injury to the ulnar nerve caused during a cut down procedure on the basilic vein.6
We therefore feel that probably the complications resulting from cut down procedures are under reported. As the procedure is usually carried out by junior doctors in an emergency situation in casualty/wards, conditions such as lighting, instrumentation, assistance, etc, are not as optimum as in an operating room. Furthermore, the overcrowding of patients in public hospitals, especially in developing countries, usually leads to physical exhaustion of the team of residents working around the clock. All these factors working in unison could lead to an increased rate of such preventable complications. However, an awareness of the complications and a high level of caution during the procedure can be helpful in avoiding such events arising.
- Venous cut down is a common minor surgical procedure.
- Knowing the complications helps to avoid them.
- Ulnar nerve injury is a major complication.
- A high level of caution during the procedure is important.
- Early diagnosis and repair of the cut ulnar nerve is important for the best results