title: Closed suction drainage improves clinical outcome in patients undergoing endoscopic vein harvesting for coronary artery bypass grafting.
abstract: BACKGROUND
  Endoscopic vein harvesting (EVH) is a widely accepted technique for coronary artery bypass grafting, with well-reported benefits. However, EVH is associated with severe hematoma formation at incision sites, resulting in postoperative pain. We hypothesized that the use of a leg wound drain at the incision site may reduce these comorbidities.
  
  
  METHODS
  One hundred consecutive patients were prospectively randomly allocated into two groups of 50: group 1 with leg wound drains, and group 2 without drains. Group 1 patients underwent EVH followed by closure with a size 10 high vacuum leg wound drain (20 kPa), whereas group 2 underwent EVH followed by closure without a leg wound drain. Patients were assessed for postoperative pain, wound infection, and satisfaction using validated scoring systems immediately after surgery.
  
  
  RESULTS
  Pain at rest (p < 0.001) and with movement (p < 0.001), incidence of hematoma (p < 0.001), and patient satisfaction (p < 0.001) were significantly improved in the drain group at days 1 to 7 and remained significant at week 6 after surgery. Interestingly, the use of antibiotics (6% versus 24%, p = 0.012) and the number of general practitioner visits (6% versus 26%, p = 0.012) were lower in the drain group compared with the no-drain group. However, there were no differences in the length of hospital stay between the two groups after surgery.
  
  
  CONCLUSIONS
  Our findings indicate that the use of a high vacuum leg drain after EVH for long saphenous vein is of clear therapeutic benefit in the early postoperative period. We also report that this technique may reduce antibiotic administration and general practitioner visits after patient discharge.
authors.affiliation: Transplant Centre, University Hospital of South Manchester NHS Foundation Trust, Manchester, United Kingdom.
authors.forename: Bhuvaneswari
authors.initials: B
authors.lastname: Krishnamoorthy
authors.forename: Othman S
authors.initials: OS
authors.lastname: Al-Fagih
authors.forename: Mohammed I
authors.initials: MI
authors.lastname: Madi
authors.forename: Osman
authors.initials: O
authors.lastname: Najam
authors.forename: Paul D
authors.initials: PD
authors.lastname: Waterworth
authors.forename: James E
authors.initials: JE
authors.lastname: Fildes
authors.forename: Nizar
authors.initials: N
authors.lastname: Yonan
mesh_terms: D000368:Aged; D001026:Coronary Artery Bypass; D004724:Endoscopy; D005260:Female; D006801:Humans; D007866:Leg / Q000098:blood supply* / Q000601:surgery; D008297:Male; D008875:Middle Aged; D017060:Patient Satisfaction; D011446:Prospective Studies; D012501:Saphenous Vein / Q000601:surgery* / Q000637:transplantation; D013396:Suction; D020858:Tissue and Organ Harvesting / Q000379:methods*; D016896:Treatment Outcome; D014945:Wound Healing