[Harvesting the vena saphena magna for aortocoronary bypass operations--is the subcutaneous suture necessary?].
BACKGROUND
The need for stitching the subcutaneous layers after saphenous vein graft harvest for coronary artery bypass is discussed controversially.


METHODS
We conducted a prospective study to determine whether subcutaneous stitches reduce the incidence of hematoma, infection and wound dehiscence after saphenous vein graft harvest in patients undergoing coronary artery bypass grafting. Patients were randomized either to group 1 (n = 100, subcutaneous suture) or group 2 (n = 46, without subcutaneous suture). Leg wounds were examined for hematoma, wound dehiscence, necrosis or secretion preoperatively and on day 2 and 5 after surgery. Furthermore, leg circumferences were measured at distinct areas.


RESULTS
There were no significant differences in the incidence of wound complications. Especially, leg circumferences and incidence of hematomas (group 1: 36% versus group 2: 39%) as well as the length of hospital stay (group 1: 6.8 days versus group 2: 6.2 days) did not differ significantly.


CONCLUSIONS
The subcutaneous suture following saphenectomy is unnecessary. A deterimental effect of an additional subcutaneous suture could not be demonstrated.
Teebken
O E
OE
Klinik für Thorax, Herz- & Gefässchirurgie, Medizinische Hochschule Hannover. teebken@thg.mh-hannover.de
Karck
M
M
Harringer
W
W
Haverich
A
A
D000368:Aged; D001026:Coronary Artery Bypass; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D012307:Risk Factors; D012501:Saphenous Vein / Q000637:transplantation*; D013529:Surgical Wound Dehiscence / Q000209:etiology*; D013530:Surgical Wound Infection / Q000209:etiology*; D013536:Suture Techniques