I may be wrong in this answer and someone please feel free to correct me. However, if I am not mistaken, a "cut-down" refers to surgically dissecting down to the vessel in order to access it (i.e. cannulation, etc...) as opposed to accessing via percutaneous technique. Saphenous "cut-down" would thus be a "cut-down" to access the saphenous vein. Unfortunately, I never had to do a cut down in surgery internship. I did however see numerous surgical cut-down type approaches to accessing groin vessels for Circ-Arrest bypass in aortic arch repairs during med-school.
Skylizard, you are correct in your answer. The saphenous cut down is usually done just anterior to the medial malleolus. A cutdown is usually done when you are unable to get an IV in by a percutaneous approach. Cut downs are done much less frequently now because central lines are much easier. I've only done them on pediatric patients on my peds surg rotation.
I've done them on trauma patients needing access who presented as hopelessly brain injured and likely to go to donation. It was a good opportunity to practice for me, and also decreased the (slight) risk of lung injury, bleeding etc associated with CVC placement.
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