Effects of Harvesting Site and Incision Method on Surgical Wound Complications of No-Touch Saphenous Vein Grafts: A Retrospective Observational Study.

Introduction: Saphenous vein grafts are frequently used for coronary artery revascularization. However, harvesting veins is associated with infected surgical sites and other complications. The no-touch technique that includes harvesting saphenous vein grafts along with surrounding tissues improves graft patency but increases the frequency of wound complications. We harvested saphenous vein grafts using the no-touch technique and devised other options for sites and incision methods to prevent wound complications. This study aimed to determine the clinical outcomes of no-touch saphenous vein grafts as well as associations between harvesting methods and wound complications.

Methods: We enrolled 132 patients who underwent isolated coronary artery bypass surgery with saphenous vein grafts harvested using the no-touch technique. Wound condition, general status, and graft patency were assessed during clinical follow-up.

Results: We harvested 180 veins (lower legs, n = 69 veins; upper legs, n = 111) using longitudinal and skip incisions at 100 and 80 sites, respectively. Wound complications occurred at 35 sites. The frequency of complications was significantly lower in the upper, than in the lower legs (14.4% vs. 27.5%). Furthermore, wound complications were reduced more by skip, than by longitudinal skin incisions (16.3% vs. 20.0%).

Conclusion: We devised a method to harvest no-touch saphenous vein grafts and determined the clinical outcomes of saphenous vein grafts and harvesting sites. Harvesting from the upper leg and via skip incisions reduced the frequency of wound complications.