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A Serious Complication of the Split-Sheath Introducer Technique for Venous Access

Brett T. Gemlo, MD; Anthony A. Rayner, MD; Robert J. Swanson, MD; James A. Young, MD; COL Joseph F. Homann, MD; David C. Hohn, MD

Arch Surg. 1988;123(4):490-492.

Abstract
• The use of split-sheath introducers to place venous access catheters results in the potential for subcutaneous extravasation and tissue injury or necrosis. We present six cases that demonstrate this complication and illustrate the probable mechanism. The safe use of these catheters requires verification that blood can be aspirated from the catheter and a high index of suspicion for extravasation when symptoms develop.

(Arch Surg 1988;123:490-492)

Author Affiliations
From the Department of Surgery, University of California, San Francisco (Drs Gemlo, Rayner, Swanson, and Hohn); the General Surgery Service, Letterman Hospital, San Francisco (Dr Homann); and the Natalie Warren Bryant Cancer Center, Tulsa, Okla (Dr Young).

Footnotes
Accepted for publication Feb 23, 1987.

Reprint requests to Department of Surgery, HSE 585, University of California, San Francisco, CA 94143 (Dr Gemlo).

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