The risk factors affecting the complications of saphenous vein graft harvesting in aortocoronary bypass surgery.
OBJECTIVE
Problem of wound healing is commonly observed after coronary artery bypass graft procedures. Our aim is to determine the prevalence and the predictors of saphenous vein harvesting complication after coronary revascularization procedures.


METHODS
After institutional ethical committee review and approval, a retrospective review was undertaken of 4029 bypass procedures with saphenous vein graft performed over a period of six years is conducted. Thirteen risk factors for those who developed major leg wound complications were analyzed and compared with the entire cohort of patients, undergoing similar bypass procedures during the same period.


RESULTS
Lower extremity wound complications occurred in 68 patients (1.7%), 43 of them required additional surgical interventions. There were 17 wound debridements, nine skin grafts, one angioplasty, 11 fasciotomies, three vascular procedures, and two free tissue transfers. Of 13 variables evaluated by multivariate analysis, female gender, BMI, use of internal thoracic artery graft, peripheral vascular disease, the use of postoperative intraaortic balloon pump and preexisting hyperlipidemia were identified as significant independent predictors of major leg wound complications (p<0.05).


CONCLUSIONS
The causes of major leg wound complications after saphenous vein harvest for coronary artery bypass graft procedures are multifactorial. To minimize these complications, we recommend vascular evaluations before saphenous vein harvest, attention to proper surgical technique, and careful harvest site section.
Abbaszadeh
Monir
M
Department of Anesthesia, Faculty of Paramedics. abbaszad@sina.tums.ac.ir
Arabnia
M K
MK
Rabbani
A
A
Mandegar
M H
MH
Vahedi
S
S
D000328:Adult; D000368:Aged; D001026:Coronary Artery Bypass / Q000009:adverse effects*; D003646:Debridement / Q000706:statistics & numerical data; D000071938:Fasciotomy; D005260:Female; D006801:Humans; D007866:Leg / Q000601:surgery; D035002:Lower Extremity / Q000601:surgery; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D012189:Retrospective Studies; D012307:Risk Factors; D012501:Saphenous Vein / Q000637:transplantation*; D013530:Surgical Wound Infection / Q000453:epidemiology / Q000209:etiology*; D020858:Tissue and Organ Harvesting / Q000009:adverse effects*