A new “closed” in situ vein bypass technique results in a reduced wound complication rate

Abstract

These results indicate that a "closed" technique reduces wound complication rate, without negative effects on the short term patency rates. The "closed" technique results in an increased number of postoperative treatments for residual arteriovenous fistulae.

Open Surgical versus Minimally Invasive in Situ Femorodistal Bypass: Long-term Results

“…[8][9][10] Although the closed operation itself costs more, the total expenditure for the closed procedure in our study was lower than the open technique due to reduced hospital costs ($6322 versus $8030). 4 More recently, Nelson et al 9 corroborated these findings in their study of 46 endovascular-assisted in situ sa-phenous vein bypass procedures versus a historical control group of conventionally treated patients.…”

“…In our initial evaluation of the entire 97-patient population from this multicenter randomized trial, [4][5][6][7] we found that the closed in situ bypass technique produced fewer wound complications (e.g., infections in 72% of open procedure patients versus 34% in the closed group), mainly due to the use of 2 short incisions, which translated into quicker wound healing and shorter hospitalization. Other investigators have published similar observations.…”

“…Unfortunately, the long or multiple skin incisions result in a high rate (up to 72%) of wound healing complications. 4 We developed a minimally invasive technique for in situ femorodistal bypass that requires only two short incisions: one at the groin and the other over the distal anastomosis site. This avoids the long skin incision and, as our early results have shown, [4][5][6][7] reduces the potential for wound complications.…”

“…4 We developed a minimally invasive technique for in situ femorodistal bypass that requires only two short incisions: one at the groin and the other over the distal anastomosis site. This avoids the long skin incision and, as our early results have shown, [4][5][6][7] reduces the potential for wound complications. The purpose of this report is to compare the long-term patency for in situ femorodistal bypass grafts created by the minimally invasive or ''closed'' technique versus the ''open'' approach.…”

Endovascular in Situ Bypass Decreases Morbidity and Hospital Stay following Infrainguinal Arterial Reconstruction

“…Reifsnyder et al 3 observed a 44% rate of wound complications following ISVB, but overall wound-related morbidity as high as 72% has been reported. 4 Recently, a less invasive method has been devised to minimize the incidence of wound complications accompanying femorodistal reconstructions. Technical advances include a minimally invasive means of performing valvulotomy.…”