Novel treatment strategy for leg and sternal wound complications after coronary artery bypass graft surgery: bioengineered Apligraf.
OBJECTIVE
To demonstrate that bioengineered Apligraf improves time to wound healing in sternal and leg wound complications after coronary artery bypass surgery.


METHODS
Between 1998 and 2001, 1,550 patients underwent coronary artery bypass surgery utilizing saphenous vein. In 45 (2.9%) of 1,550 patients, leg wound complications developed (group A); and in 15 (0.9%) of 1,550 patients, sternal wound complications developed (group B). Apligraf was utilized as the primary treatment for 30 (66%) of 45 leg wounds and for 9 (60%) of 15 sternal wounds. Traditional wound care included debridement and daily wet-to-dry dressings.


RESULTS
Time to wound healing ranged from 26 to 72 days (mean, 46) for Apligraf group A and from 34 to 120 days (mean, 84) for traditional wound care group A. The time to wound healing ranged from 21 to 80 days (mean, 39) for Apligraf group B, and from 36 to 110 days (mean, 62) for traditional care group B. Apligraf treatment was simpler, with less time and resource utilization than traditional wound care.


CONCLUSIONS
Apligraf significantly improves time to wound healing in patients with leg and sternal wound complications and offers an attractive new treatment alternative to traditional wound care.
Allie
David E
DE
Cardiovascular Institute of the South and Southwest Medical Center, Lafayette, Louisiana, USA. david.allie@cardio.com
Hebert
Chris J
CJ
Lirtzman
Mitchell D
MD
Wyatt
Charles H
CH
Keller
V Antoine
VA
Souther
Stella M
SM
Allie
Adam A
AA
Mitran
Elena V
EV
Walker
Craig M
CM
D000368:Aged; D000789:Angina, Unstable / Q000601:surgery; D001684:Biological Dressings; D001026:Coronary Artery Bypass; D016207:Cytokines / Q000378:metabolism; D048909:Diabetes Complications / Q000628:therapy; D016326:Extracellular Matrix Proteins / Q000096:biosynthesis; D005260:Female; D005347:Fibroblasts / Q000378:metabolism; D006133:Growth Substances / Q000378:metabolism; D006801:Humans; D007866:Leg / Q000098:blood supply / Q000601:surgery*; D008297:Male; D018919:Neovascularization, Physiologic; D010027:Osteotomy; D011183:Postoperative Complications / Q000601:surgery*; D012189:Retrospective Studies; D012501:Saphenous Vein / Q000601:surgery*; D017768:Skin, Artificial; D013249:Sternum / Q000601:surgery*; D013529:Surgical Wound Dehiscence / Q000628:therapy*; D023822:Tissue Engineering; D020858:Tissue and Organ Harvesting / Q000009:adverse effects*; D014945:Wound Healing
D016207:Cytokines; D016326:Extracellular Matrix Proteins; D006133:Growth Substances