What is a Cutdown?

QUESTION: Our mother was very ill recently, and required a great deal of
care. They had a great deal of trouble with giving her intravenous fluids,
because her veins were so hard to find. At one time they discussed using "a
cutdown", but fortunately a young resident doctor managed to put the needle
back in, and the cutdown was never used. We are still wondering what it is,
and how they were going to use it. Please explain?
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ANSWER: A cutdown is a minor surgical procedure, not a thing. It is used
when it is impossible or dangerous to locate a vein large enough to put a
needle into. In older patients and the very young, or in obese patients, or
when veins are collapsed because the patient is dehydrated, a cutdown may be
the only method to find a suitable vessel that can serve to administer the
vital fluids necessary for care and treatment. Other methods which permit the
placing of catheters in the larger or more accessible veins of the body are
replacing the surgical cutdown, but there are times when it is the only
solution available. The name comes from the technique which, under local
anesthetic and with sterile precautions, incises the skin and "cuts down" to
the location of a vein which may be found deeper in the arm or leg. The vein
is punctured and a cannula (a small tube) is inserted and tied in place. The
end of the cannula is then connected to the plastic tubes that lead to the
bottles of fluid. The cannula is usually changed frequently to prevent
inflammation, but as soon as the condition of the patient permits, the cutdown
is removed and replaced by a routine I.V. (intravenous) needle and tube.