Open technique has lower evidence of complications

doi:10.1136/bmj.311.7012.1090a

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M D Richards,
J Hill,
N A Scott,
J Bancewicz,
Miles Irving

Tutor in surgery Senior registrar in surgery Consultant general surgeon Reader in surgery Professor of surgery Department of Surgery, Hope Hospital, Salford M6 8HD

EDITOR,--We disagree with Andy Adam's comments regarding the drawbacks of an open surgical technique for placing long term central venous catheters. It is our practice to place such catheters by using an open cutdown technique under local anaesthesia. We mainly use the cephalic vein, with fluoroscopic screening to ensure correct positioning. With this technique more than 800 catheters have been inserted over the past 10 years, for parenteral nutrition, antibiotics, and chemotherapy. The incidence …