Leg wound infections following cardiac surgery: a scoring system for assessment and management.
OBJECTIVE
Well-defined criteria are needed to provide guidance for the appropriate management of leg wounds following saphenous vein harvest in coronary artery bypass graft surgery (CABG).


METHODS
A score named DISINFECT was devised to carefully define the variables to be considered for assessing saphenous vein harvest wounds.


RESULTS
This preliminary study included 100 consecutive patients undergoing first-time isolated CABG requiring the saphenous vein as a conduit. Wounds were assessed and the points combined to create a daily score (D) according to the presence of increased C-reactive protein/white blood cells (I), surrounding tissue (S), quality of the incision (I), new skin (N), foreign material (F), exudate (E), positive cultures (C) and temperature (T).


CONCLUSIONS
Taking into account the stages of wound healing, severity of infection and appropriate use of antibiotics, this method of wound management would improve the consistency with which leg wounds are managed, reduce hospital stays and increase resistance to hospital-acquired infection.
Elahi
M M
MM
Department of Cardiothoracic Surgery, Glenfield Hospital, Leicester, UK.
Haesey
A M
AM
Graham
K C
KC
Battula
N R
NR
Manketlow
B
B
Dhannapuneni
R R V
RR
Hickey
M St
MS
D000368:Aged; D000369:Aged, 80 and over; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D001026:Coronary Artery Bypass / Q000009:adverse effects*; D005122:Exudates and Transudates; D005260:Female; D006801:Humans; D007866:Leg / Q000098:blood supply*; D008297:Male; D008875:Middle Aged; D009730:Nursing Assessment / Q000379:methods* / Q000592:standards; D015403:Nursing Evaluation Research; D009737:Nursing Records / Q000592:standards; D015588:Observer Variation; D011237:Predictive Value of Tests; D012307:Risk Factors; D012501:Saphenous Vein / Q000637:transplantation*; D012720:Severity of Illness Index; D017592:Skin Care / Q000379:methods / Q000451:nursing; D013492:Suppuration; D013530:Surgical Wound Infection / Q000145:classification / Q000175:diagnosis / Q000209:etiology / Q000628:therapy; D020858:Tissue and Organ Harvesting / Q000009:adverse effects; D014945:Wound Healing
D000900:Anti-Bacterial Agents