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Multiple Skin Bridging for No-Touch Saphenous-Vein Grafts Harvesting Can Reduce Wound Morbidity
Kang Zhou1, Xiaoke Qi1, Shijie Wei1
1Department of Cardiovascular Surgery, The Second Xiangya Hospital, Central South University, Changsha, China. drzhaoyuan@csu.edu.cn.
Insights
The skin bridging technique for no-touch great saphenous vein harvesting in coronary artery bypass grafting significantly reduces leg wound morbidity. This method maintains one-year bypass graft patency without compromising patient outcomes.
Area of Science:
- Cardiovascular Surgery
- Vascular Surgery
- Surgical Techniques
Background:
- Minimizing leg wound complications is critical after coronary artery bypass grafting (CABG) using no-touch (NT) great saphenous vein (SV) grafts.
- The NT technique aims to preserve vein quality, but leg wound morbidity remains a concern.
Purpose of the Study:
- To evaluate the efficacy of the skin bridging technique in reducing wound morbidity during NT SV harvesting for CABG.
- To assess the impact of the skin bridging technique on one-year bypass graft patency.
Main Methods:
- A comparative study involving 60 patients undergoing CABG with SV grafts, divided into open-incision NT and skin bridging NT groups (30 each).
- Analysis of harvesting times, graft length, bleeding branches, postoperative subjective perception assessment scale (ASEPSIS) scores, and one-year graft patency.
- Data collected from June 2018 to February 2019.
Main Results:
- The skin bridging NT group experienced significantly longer harvest times and a greater number of bleeding branches compared to the open NT group.
- The open NT group reported significantly higher ASEPSIS scores, indicating greater wound morbidity.
- No significant difference in one-year bypass graft patency was observed between the two groups.
Conclusions:
- The combined NT and discontinuous skin bridging technique for SV harvesting is a satisfactory approach for CABG patients.
- This technique significantly reduces wound morbidity associated with NT graft harvesting.
- The method demonstrates clinical importance in improving patient recovery after CABG.
Background:
Reducing the leg wound morbidity is crucial for the patients undergoing coronary artery bypass grafting (CABG) with great saphenous vein (SV) grafts harvested by no-touch (NT) technique. This study was to summarize the experience of skin bridging technique for reducing wound morbidity and the influence of it on one-year bypass graft patency.
Methods:
According to skin bridging or not, harvesting times, graft length, number of bleeding branches, postoperative subjective perception assessment scale (ASEPSIS) scores and one-year patency rate were analyzed.
Results:
From June 2018 to February 2019, 60 patients underwent CABG with SV grafts either with open-incision NT or skin bridging NT (30 in each group). There were no significant differences in age (71.4 ± 5.1 years vs. 68.9 ± 5.5 years) or graft length (23.3 ± 1.1 cm vs. 23.9 ± 1.3 cm) between the two groups. The bridging/NT group had a significantly longer harvest time (38.5 ± 4.9 min vs. 18.5 ± 2.6 min; P < 0.001) and a significantly greater number of bleeding branches (1.9 ± 1.2 vs. 0.8 ± 0.8; P < 0.001) than the open NT group. The open NT group had a significantly higher ASEPSIS score (23.8 ± 2.0 vs. 15.7 ± 2.6; P < 0.001). There was no significant difference in patency rate at one-year follow-up.
Conclusion:
Obtaining the SV by the combined NT/discontinuous skin bridging technique is a satisfactory method for patients who underwent CABG. This method has important clinical significance in reducing wound morbidity in the harvest of NT grafts.
