Tunneled CVCs? Cutdown?

A tunneled central venous catheter would be something like a Hickman or Mediport that is placed in the OR. Where you see the catheter come thru the skin is not where it enters the vein.

This is still a type of cutdown as a skin incision is made.

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It is different from what we used to call cutdowns, usually seen quite some time ago. In a trauma patient, if they had difficulties finding a vein right away, they made a small incision at the elbow area, usually, and found the brachial vein and then inserted a catheter into it, and closed the skin. Same thing for arterial lines, you do not see it done much anymore. They did cutdowns also for cardiac catheters back then as well. Biggest issue was that the patient usually developed scar tissue in that area, and good have vascular issues later on.