Leg wound infections following cardiac surgery: a scoring system for assessment and management

Well-defined criteria are needed to provide guidance for the appropriate management of leg wounds following saphenous vein harvest in coronary artery bypass graft surgery (CABG).

A score named DISINFECT was devised to carefully define the variables to be considered for assessing saphenous vein harvest wounds.

This preliminary study included 100 consecutive patients undergoing first-time isolated CABG requiring the saphenous vein as a conduit. Wounds were assessed and the points combined to create a daily score (D) according to the presence of increased C-reactive protein/white blood cells (I), surrounding tissue (S), quality of the incision (I), new skin (N), foreign material (F), exudate (E), positive cultures (C) and temperature (T).

Taking into account the stages of wound healing, severity of infection and appropriate use of antibiotics, this method of wound management would improve the consistency with which leg wounds are managed, reduce hospital stays and increase resistance to hospital-acquired infection.