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Open saphenectomy complications following lower extremity revascularization
R L Dalman1, T Abbruzzese, T Bushnik
1Vascular Section, Surgical Service, Veterans Affairs Palo Alto Health Care System, CA 94304, USA.
Cardiovascular Surgery (London, England)
|February 8, 2000
Summary
Wound complications after lower extremity revascularization occur in 24% of procedures, primarily at arterial access sites. Higher body mass index is the only predictor of these saphenectomy site complications.
Area of Science:
- Vascular Surgery
- Surgical Complications
- Lower Extremity Revascularization
Background:
- Saphenectomy, the removal of the saphenous vein, is a common procedure in lower extremity revascularization.
- Wound complications at incision sites can impact patient outcomes and increase healthcare costs.
Purpose of the Study:
- To review saphenectomy site complications following lower extremity revascularization.
- To identify patient and procedural risk factors associated with wound complications.
- To report outcomes of infrainguinal bypass procedures.
Main Methods:
- A review of 133 consecutive infrainguinal bypass procedures was conducted.
- Leg incisions were categorized by location.
- Patient and procedural risk factors were analyzed for wound complication risk.
- Outcomes were reported using life table analysis.
Main Results:
- Incisional wound complications occurred in 32/133 procedures (24%).
- The most frequent complications were at arterial access incisions (75%).
- Higher body mass index (BMI) was the only significant predictor of wound complications (P < 0.05).
- Saphenectomy site complications occurred in only 6% of great saphenous (GS) vein bypass procedures.
Conclusions:
- Incisional complications following bypass grafting are associated with body mass index.
- Limiting saphenectomy size may not significantly reduce incisional morbidity.
- Most bypass-related wound complications involve arterial access incisions.