The Risk Factors Affecting the Complications of Saphenous Vein Graft Harvesting in Aortocoronary Bypass Surgery

Abstract

Problems of wound healing are commonly observed after coronary bypass grafting (CABG) operations. Our aim is to determine the prevalence and the predictors of saphenous vein harvesting complications after coronary artery bypass surgery. One hundred twenty six patients operated in the specified period were included in this prospective study. In an early period 3 patients were excluded because of their mortality. Twenty patients were female and 103 were male. Forty three patients underwent an open procedure with one incision (35%), 61 patients also underwent an open procedure but with multiple incisions (49%), and 19 patients underwent a closed procedure with stripper (16%). Complications related with leg incisions after surgery were investigated. Multiple incision technique has the longest (49.28 ± 14.7 cm; p < 0.001) total incision length (compare to single incision and stripper technique). As incision length increases, the incidence of drainage ( p < 0.01), pain score ( p < 0.05), hematoma ( p < 0.05) and diffuse ecchymosis ( p < 0.05) were increased. Drainage was seen more frequently in female ( p < 0.001) and diabetic patients ( p < 0.05). Sex ( p < 0.001) and incision length ( p < 0.05) have been found independent risk factors for drainage complication. Superficial infection ( p < 0.05), pain ( p < 0.05) and dehiscence ( p < 0.05) were significantly higher in female patients. As the incision length of the multiple incision technique became longer, the risk of drainage, pain, hematoma and diffuse ecchymosis were increased. The significantly increased risk for wound complications were also seen in female gender, diabetic and obese patients.saphenectomy; saphenous vein harvesting; coronary artery bypass surgery; wound; complication © 2007 Tohoku University Medical PressDespite the widespread use and superior patency of the internal mammarian artery and other arterial conduits, the saphenous vein continues to be the most commonly used conduit for coronary artery bypass graft surgery due to its length and lack of invasiveness. Open and also closed surgical techniques exist for the harvesting greater saphenous vein. However, problems of

Endoscopic vs open saphenous vein harvest for coronary artery bypass grafting: a prospective randomized trial☆

“…In previous studies it has been shown that the incidence of leg wound morbidity increases with the length of the incision [18,19].…”

Fatores de risco que afetam as complicações da dissecação da veia safena na revascularização cirúrgica do miocárdio

“…They concluded that leg wound complications were more likely to occur in obese women. In 2007, a prospective study by Kayacioglu et al [4] found the significantly increased risk for wound complications were also seen in female gender, diabetic and obese patients. Fowler et al [6] found a major infection of the saphenous harvest site, occurred in 32.6% of a population of 11.636 patients, after CABG.…”

“…The reported incidence of leg wound complications after GSV harvest ranges from 1to 24% [2][3][4][5], with one series as high as 32.6% [6]. Commonly reported leg wound complications include dermatitis, cellulites, grater saphenous neuropathy, chronic non-healing wounds, and lymphocoele [6][7][8][9].…”

Saphenous vein harvest wound complications: risk factors, identification, prevention, and management

“…12,22 The reason why females are more prone to SV infection is not clear. It has been suggested that females have smaller peripheral arteries than males, which may impair wound healing.…”