Effect of preoperative ultrasound mapping of the saphenous vein on leg wound complications after coronary artery bypass surgery: a systematic review

Abstract

BackgroundThe long saphenous vein is one of the most used conduits for coronary artery bypass graft surgery. The aim of this study was to assess the existing evidence regarding the effects of preoperative ultrasound mapping of the long saphenous vein with special attention to leg wound complications in patients undergoing elective coronary artery bypass graft surgery.Main textA systematic literature search was conducted in PubMed, Cochrane, and Embase databases. Extraction of relevant data was performed including study characteristics, patient characteristics, and all reported outcomes. The Cochrane Risk of Bias tool was used to evaluate the risk of bias of the included studies. The primary outcome measure was leg wound infections.Of 4514 papers screened in this systematic review, 36 papers underwent full-text assessment with final inclusion of 5 studies; 3 observational studies, and 2 randomized trials. The two randomized controlled trials showed no effects of preoperative ultrasound. Data from the three non-randomized studies was pooled in a meta-analysis, which suggested a significant reduction in the risk of harvest wound complications by ultrasound mapping prior to surgery (RR 0.32; 95%CI = [0.19–0.55]).ConclusionsThe main findings of this systematic review showed, that (1) the evidence in this field is limited and of low quality, i.e., low power or methodology and (2) despite limitations of the included studies, preoperative ultrasound mapping of the saphenous vein seems to be beneficial in terms of reducing the risk of postoperative leg wound complications.