Prediction of and risk factors for surgical wound infection in the saphenous vein harvesting leg in patients undergoing coronary artery bypass.
BACKGROUND
Surgical wound infection (SWI) of the leg after saphenous vein harvesting is an important complication of coronary artery bypass graft (CABG) procedures. SWIs may restrict mobility in the postoperative period and increase costs of postoperative hospitalisation and antibiotic treatment.


METHODS
A total of 356 patients were followed. Surgical risk factors were evaluated for SWI following saphenous vein harvesting, and the effectiveness of an occlusive glycerinated hydrogel dressing in reducing postoperative SWIs was assessed. In addition, the ability of postoperative clinical wound assessment to predict SWI following CABG 30 and 60 days after operation was investigated.


RESULTS
The most important risk factor for SWI after saphenous vein harvesting was the use of a monofilament suture for skin closure (glycomer 4-0 Biosyn Tyco Healthcare, Stockholm, Sweden) (p > 0.001). The hydrogel dressing did not prevent the development of SWIs. The clinical wound assessment showed that wound gap was associated with leg infection, but other signs were poor predictors of SWI.


CONCLUSIONS
The choice of suture and suturing technique is important to prevent SWI following saphenous vein harvesting. More precise definitions of wound signs are necessary if they are to be used as predictors of SWI.
Swenne
C L
CL
Department of Cardiothoracic Surgery, Uppsala University Hospital, OTM divisionen ing 40, 4 tr, 751 85 Uppsala, Sweden. christine.leo.swenne@akademiska.se
Borowiec
J
J
Carlsson
M
M
Lindholm
C
C
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D047070:Bandages, Hydrocolloid; D001026:Coronary Artery Bypass; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007866:Leg / Q000098:blood supply*; D008297:Male; D008323:Mammary Arteries / Q000601:surgery; D008875:Middle Aged; D009779:Occlusive Dressings; D011237:Predictive Value of Tests; D017534:Radial Artery / Q000601:surgery; D012307:Risk Factors; D012501:Saphenous Vein / Q000601:surgery* / Q000637:transplantation; D013530:Surgical Wound Infection / Q000453:epidemiology* / Q000209:etiology* / Q000517:prevention & control; D013536:Suture Techniques; D013997:Time Factors; D016896:Treatment Outcome