Phlebotomy

Phlebotomy, incision of a vein for the purpose of bloodletting. Phlebotomy was in former times very widely practiced and was performed for the most diverse indications. It was more often performed not by physicians, but by barbers and bathhouse attendants. At the present time, phlebotomy is applied in the following cases: for lowering blood pressure in hypertension, depending on various causes, in pneumonia, uremia, apoplexy, etc. Especially often phlebotomy is performed for blood transfusions (see). Phlebotomy also has to be performed for the introduction of medicinal substances in subjects with poorly developed subcutaneous veins or with great development of subcutaneous fat, when it is not possible to enter the vein by a simple puncture through the skin. Phlebotomy is most often performed in the bend of the elbow, but in the absence of well-developed veins here, it is convenient to perform phlebotomy on the veins of the dorsum of the foot or hand. - Technique of phlebotomy: application of a rubber tourniquet to the limb above the site of operation (not until the pulse disappears on the radial artery), disinfection of the skin with alcohol, iodine, then again with alcohol to wash off the iodine, which interferes with seeing the translucent vein. In the bend of the elbow, it is most convenient to perform phlebotomy on the median basilic vein, over which a small incision of the skin and subcutaneous tissue (usually under local anesthesia) 2-3 cm long is made. With two anatomic forceps, the vein is dissected, and its wall is pierced with the point of a scalpel. At the end of the operation, the tourniquet is removed, and the flow of blood usually stops by itself; if not, a ligature should be applied to the peripheral part of the exposed vein. If phlebotomy is performed for blood transfusion or the introduction of medicinal substances, the tourniquet is removed immediately after the vein is opened, after which 1-2 clips are applied to the skin and a dressing is applied.