Long saphenous vein harvesting site infection after coronary artery bypass grafting

Abstract

Introduction Coronary artery bypass grafting is a very common surgery with highly successful outcomes; however, wound complications from harvesting the long saphenous vein (LSV) can be a major source of postoperative morbidity. The aim of this study was to identify the incidence of LSV harvesting site infection in coronary artery bypass grafting and to detect the possible risk factors. Patients and methods Between September 2009 and December 2010, 100 patients who were diagnosed with coronary artery disease were included in our study and were admitted at Shebien El-Kom Teaching Hospital. All patients who developed major leg wound complication were assessed daily during the postoperative period using the ASEPSIS scoring system and 10 risk factors were analyzed and compared with the entire cohort of patients undergoing similar bypass procedure during the same time period. Results LSV harvesting site infections (ASEPSIS score >20) were identified in 12 patients (12%), including nine patients with mild infection (ASEPSIS score 21-30), two with moderate infection (ASEPSIS score 31-40), and one with severe infection (ASEPSIS score >40). Of the 10 variables evaluated using multivariate analysis, age, sex, obesity, smoking, diabetes, peripheral vascular disease, level of LSV harvesting, usage of intra-aortic balloon pump, Cardio-Pulmonary Bypass (CPB) time, and use of internal thoracic artery graft were identified as significant independent predictors of major leg wound complications (P Conclusion Identification of independent risk factors for infection is important to develop strategies that prevent infection and to allow for recognition of patients at high risk who may need more careful monitoring so as to prevent development of infection.