Comparative study of traditional long incision vein harvesting and multiple incisions with small skin bridges in patients with coronary artery bypass grafting at King Abdullah University Hospital--Jordan.
OBJECTIVE
Saphenous vein harvesting can be associated with wound complications, incision pain, infection, and poor cosmetic outcome. The objective of our study is to determine the difference in wound complication and infection rates between two saphenous vein harvesting techniques, long incision versus multiple short interrupted incisions (tunneling) for coronary artery bypass grafting at the King Abdullah University Hospital--Jordan.


METHODS
Retrospectively we analyzed data from 1,050 consecutive elective coronary artery bypass procedures performed from May 5, 2003, to December 31, 2007, in our institution. Saphenectomy using traditional Long incision vein harvesting (Group 1) performed in six hundred and fifty patients (n=650), while saphenectomy using multiple incisions with small skin bridges--tunneling (Group 2) performed in four hundred patients (n=400). Saphenectomy performed by the cardiac surgery assistant or main cardiac surgeon. Inflammation, dehiscence, cellulites, lymphangitis, drainage, necrosis, or abscess necessitating dressing, antibiotics or debridement before complete healing without eschar were defined as wound complications. There was no statistical difference in preoperative risk factors in both groups. Test results were considered significant when P<0.05.


RESULTS
Leg wound complications observed more in traditional long incision vein harvesting technique (P=0.0005). Female gender, obesity, diabetes are associated with an increased incidence of wound problems (P<0.05).


CONCLUSIONS
Saphenous vein harvest using saphenous vein tunneling was associated with fewer wound complications than the traditional longitudinal method.
Hijazi
Emad Mohamed
EM
Medical College in Cardiac Surgery. emad_hijazi@hotmail.com
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001026:Coronary Artery Bypass / Q000009:adverse effects* / Q000379:methods; D005260:Female; D006801:Humans; D007597:Jordan; D007866:Leg / Q000382:microbiology*; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D012501:Saphenous Vein / Q000601:surgery*; D013530:Surgical Wound Infection / Q000209:etiology*; D020858:Tissue and Organ Harvesting / Q000009:adverse effects / Q000379:methods*