Above-knee vein harvest for coronary revascularization increases ASEPSIS score.
The long saphenous vein may be harvested from the thigh or the lower leg, depending on the operating surgeon's preference. This prospective study compared the incidence of altered wound healing between these two sites in 175 patients undergoing routine coronary artery bypass grafting over a 3-month period. The patients were divided into 3 groups. In group A, the vein harvest site was restricted to above the upper border of the patella. Group B included harvest sites that started at the ankle but extended above the level of the upper border of the patella. In group C, the vein harvest site was restricted to below the upper border of the patella. The wounds were assessed daily using the ASEPSIS scoring system. In group A, significantly more patients (24%) had an ASEPSIS score > 10, compared to group B (3%) and group C (2%). The mean ASEPSIS score was significantly lower in group C than groups A or B, 1.5 +/- 2.4 vs. 6.5 +/- 3.2 or 3.7 +/- 1.7, respectively. The ASEPSIS score is reduced when vein harvest is restricted to below the level of the knee.
Akowuah
Enoch
E
Department of Cardiothoracic Surgery, Derriford Hospital, Plymouth PL6 8DH, England, United Kingdom. akowuah@yahoo.com
Shrivastava
Vivek
V
Ponniah
Alan
A
Jamnadas
Binal
B
Chilton
Gary
G
Cooper
Graham
G
D000368:Aged; D015331:Cohort Studies; D001026:Coronary Artery Bypass / Q000009:adverse effects / Q000379:methods*; D005260:Female; D006801:Humans; D007866:Leg / Q000601:surgery; D008297:Male; D008875:Middle Aged; D015588:Observer Variation; D011183:Postoperative Complications / Q000175:diagnosis* / Q000517:prevention & control; D011446:Prospective Studies; D012501:Saphenous Vein / Q000637:transplantation*; D012720:Severity of Illness Index; D013848:Thigh / Q000601:surgery; D014945:Wound Healing; D014946:Wound Infection / Q000175:diagnosis* / Q000517:prevention & control