Faculty Collaboration Database

Wound complications of the in situ saphenous vein bypass technique. J Vasc Surg 1992 May;15(5):843-8; discussion 848-50

Date

05/01/1992

Pubmed ID

1578540

DOI

10.1067/mva.1992.36658

Scopus ID

2-s2.0-0026777253 (requires institutional sign-in at Scopus site)   96 Citations

Abstract

Wound complications after in situ saphenous vein bypass occur frequently, lengthen hospitalization, and threaten graft viability. From May 1981 to March 1991, 117 consecutive male patients underwent 126 in situ operations: 45 (36%) femoropopliteal, 75 (59%) femorotibial, and 6 (5%) grafts to the dorsal pedal artery for gangrene or ulcer (n = 69), rest pain (n = 54), or claudication (n = 3). Wound complications developed in 55 grafts (44%): erythema developed in 11, but they healed primarily, 19 had skin edge necrosis or localized lymph leaks, 12 had necrosis or infection into the subcutaneous tissue without danger to the graft, and invasive infections that threatened the graft developed in 13. Risk factors for a subsequent wound infection included the development of a lymph leak (p less than or equal to 0.05) and early postoperative graft revision for thrombosis, wound hematoma, retained valve or arteriovenous fistula (p less than or equal to 0.05). The mean time to appearance of a graft-threatening wound infection was 31 days, and 10 of 13 were located in the distal limb. Twelve of the 13 deep infections required operative debridement, and seven required a flap or split thickness skin graft for coverage. Gram-negative as well as gram-positive infections responded equally well. No grafts were lost, and no deaths occurred. Despite the high incidence of wound complications, an aggressive therapy regimen permitted universal graft salvage.

Author List

Reifsnyder T, Bandyk D, Seabrook G, Kinney E, Towne JB

MESH terms used to index this publication - Major topics in bold

Adult
Aged
Aged, 80 and over
Chi-Square Distribution
Humans
Male
Middle Aged
Necrosis
Retrospective Studies
Risk Factors
Saphenous Vein
Severity of Illness Index
Surgical Wound Infection
Time Factors