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Leg wound complications associated with coronary revascularization
The Journal of Thoracic and Cardiovascular Surgery
|March 1, 1981
Summary
Leg wound complications after saphenous vein harvest for coronary revascularization are infrequent but serious, impacting patient recovery and hospital costs. Prevention strategies focus on minimizing dissection and ensuring proper wound closure.
Area of Science:
- Cardiovascular Surgery
- Wound Healing
- Infectious Disease
Background:
- Coronary revascularization frequently utilizes saphenous vein grafts.
- Leg wound complications following vein harvest can prolong recovery and increase healthcare costs.
Observation:
- One percent of 2,545 patients experienced leg wound complications post-saphenous vein harvest.
- Major complications included debridement (13/27) and skin grafting (5/13).
- Infections occurred in 8 patients, with Staphylococcus aureus and mixed gram-negative flora identified.
Findings:
- Thigh wounds constituted 93% of complications.
- Patients with complications had a higher incidence of women (40%) compared to controls.
- Hospital stay significantly increased for patients with wound complications (24 days vs. 12.1 days).
Implications:
- Leg wound complications, though infrequent, represent a significant and costly issue in coronary revascularization.
- Preventive measures should emphasize meticulous surgical technique, including minimal dissection, hemostasis, and layered closure.
- Effective management of complications, such as wide excision and direct closure, is crucial for reducing hospital stay and the need for skin grafts.