title: Open saphenectomy complications following lower extremity revascularization.
abstract: A review of saphenectomy site complications following lower extremity revascularization was conducted. Leg incisions used for 133 consecutive infrainguinal bypass procedures were categorized by location. Patient and procedural risk factors were analyzed for risk of wound complications. Procedure, limb and patient outcome were reported via life table analysis. Incisional wound complications followed 32/133 procedures (24%), including 15 groin, eight saphenectomy, five distal and four vein/distal incisions. There were five grade I and three grade II saphenectomy complications. Only weight (body mass index) predicted the likelihood of wound complication (P < 0.05). The 6-month primary patency rate was 79% (mean follow-up 22 months). Four-year assisted primary patency, limb salvage and survival rates were 75, 87 and 57%, respectively. Most bypass-related wound complications (24/32, 75%) involve arterial access incisions. Incisional complications are related to body mass index. Only 6% of GS vein bypass procedures develop saphenectomy site complications. Limiting saphenectomy size may not significantly reduce incisional morbidity following bypass grafting.
authors.affiliation: Vascular Section, Surgical Service, Veterans Affairs Palo Alto Health Care System, CA 94304, USA.
authors.forename: R L
authors.initials: RL
authors.lastname: Dalman
authors.forename: T
authors.initials: T
authors.lastname: Abbruzzese
authors.forename: T
authors.initials: T
authors.lastname: Bushnik
authors.forename: E J
authors.initials: EJ
authors.lastname: Harris
mesh_terms: D000328:Adult; D000368:Aged; D005260:Female; D005500:Follow-Up Studies; D006083:Graft Occlusion, Vascular / Q000209:etiology; D006119:Groin / Q000098:blood supply / Q000382:microbiology; D006801:Humans; D007866:Leg / Q000098:blood supply* / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000209:etiology*; D012501:Saphenous Vein / Q000601:surgery*; D013203:Staphylococcal Infections / Q000209:etiology; D013530:Surgical Wound Infection / Q000209:etiology; D015996:Survival Rate; D016896:Treatment Outcome; D014654:Vascular Patency; D014656:Vascular Surgical Procedures / Q000009:adverse effects* / Q000401:mortality