Major leg wound complications after saphenous vein harvest for coronary revascularization

Background. Major leg wound complications after coronary artery bypass graf t procedures are infrequent and few are reported in the Literature. We pres ent our experience in treating 23 patients with major leg wound complicatio ns after coronary revascularization procedures Methods. A retrospective review of 3,525 bypass procedures with saphenous v ein grafts performed over a 10-year period was conducted. Ten potential ris k factors for those who developed major leg wound complications were analyz ed and compared with the entire cohort of patients undergoing similar bypas s procedures during the same period. Results. Lower extremity wound complications occurred in 145 patients (4.1% ), 23 of whom (0.65%) required additional surgical interventions (62 total) . There were 32 wound debridements, 8 skill grafts, 11 vascular procedures, 5 amputations, 3 fasciotomies, 2 free tissue transfers, and 1 fasciocutane ous nap Of ten variables evaluated by multivariate analysis, female gender, peripheral vascular disease, and postoperative intraaortic balloon pump us e were identified as significant independent predictors of major leg wound complications (p < 0.0001). Conclusions. The causes of major leg wound complications after saphenous ve in harvest for coronary artery bypass graft procedures are multifactorial. To minimize these complications, we recommend vascular evaluations before s aphenous vein harvest, attention to proper surgical technique, and careful harvest site selection. (C) 2000 by The Society of Thoracic Surgeons.