A retrospective review of leg wound complications after coronary artery bypass surgery.
Little research or attention has been paid to finding out whether wound closure with sutures or staples attains the best outcomes after saphenous vein harvest for coronary artery bypass grafting. We undertook a quality improvement project to compare the prevalence of leg wound complications (eg, infection, seroma, hematoma, dehiscence) between two types of skin closure (ie, staples, subcuticular sutures) after conventional open surgery with bridging between incisions and vein harvesting during coronary revascularization to determine the need for practice changes. We found no significant differences between patients with wound complications and those without. However, in this project, the risk for infections was greater for patients with diabetes whose wounds were closed by using subcuticular sutures. These findings have led to practice changes for reducing leg wound complications within our institution: clinicians now assess patients for increased risk of leg wound complications preoperatively and opt to close wounds with staples for patients who have diabetes.
Susan A
SA
East
Rebecca A
RA
Lorenz
Eric S
ES
Armbrecht
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001026:Coronary Artery Bypass / Q000009:adverse effects*; D005260:Female; D006801:Humans; D007866:Leg / Q000473:pathology*; D008297:Male; D008875:Middle Aged; D015146:Midwestern United States; D012189:Retrospective Studies; D012307:Risk Factors; D014947:Wounds and Injuries / Q000209:etiology*
CABG; RNFA; coronary artery bypass grafting; coronary artery disease; diabetes; leg wound closures; postoperative wound complications; registered nurse first assistant; saphenous vein harvest