INTRODUCTION: Wound infection is one of the major complication post CABG that leads to prolonged length of stay and cost post surgery. Coronary artery bypass grafting is one of the most commonly performed operations in the world. The long saphenous vein harvested by traditional techniques is still widely used and caries a risk of wound infection. OBJECTIVE: The purpose of this study is to ascertain if a single-layer closure result in better wound healing and functional outcome as compared with the traditional two-layer closure after harvest of saphenous vein. METHODS:Sixty-seven consecutive patients undergoing CABG were prospectively randomized to have their leg wound closed by either a single-layer technique with a suction drain or double layers without suction drain. All wounds were assessed for the presence of serous discharge, inflammation, edema, purulent exudates, infection of the deep tissues, and pain postoperatively and two weeks after discharge. RESULTS: There were trends towards increased rates of wound related outcomes in patients in double layer group when compared with single layer group. Out of 77 patients in our study, 52 patients underwent single layer closure (males, n = 37; females, n= 15) and 25 patients underwent double layer closure (males, n = 21; females, n = 04). There was significant statistical difference between the treatment groups with single layer group having lower average scores (4.038) compared to double layer group (9.467), P- value 0.001. Patients whose legs were closed with the single layer technique had less post operative edema (23.07% vs 53.30) and pain (44.2 vs 73.33) compared with the double layer group. CONCLUSIONS:Single-layer leg wound closure over a suction drain has shown a better wound outcome compared to traditional double-layer closure. A possible mechanism of better wound healing in the former technique might be through decreased tissue handling and a reduction in leg edema.
RCT Entities:
INTRODUCTION: Wound infection is one of the major complication post CABG that leads to prolonged length of stay and cost post surgery. Coronary artery bypass grafting is one of the most commonly performed operations in the world. The long saphenous vein harvested by traditional techniques is still widely used and caries a risk of wound infection. OBJECTIVE: The purpose of this study is to ascertain if a single-layer closure result in better wound healing and functional outcome as compared with the traditional two-layer closure after harvest of saphenous vein. METHODS: Sixty-seven consecutive patients undergoing CABG were prospectively randomized to have their leg wound closed by either a single-layer technique with a suction drain or double layers without suction drain. All wounds were assessed for the presence of serous discharge, inflammation, edema, purulent exudates, infection of the deep tissues, and pain postoperatively and two weeks after discharge. RESULTS: There were trends towards increased rates of wound related outcomes in patients in double layer group when compared with single layer group. Out of 77 patients in our study, 52 patients underwent single layer closure (males, n = 37; females, n= 15) and 25 patients underwent double layer closure (males, n = 21; females, n = 04). There was significant statistical difference between the treatment groups with single layer group having lower average scores (4.038) compared to double layer group (9.467), P- value 0.001. Patients whose legs were closed with the single layer technique had less post operative edema (23.07% vs 53.30) and pain (44.2 vs 73.33) compared with the double layer group. CONCLUSIONS: Single-layer leg wound closure over a suction drain has shown a better wound outcome compared to traditional double-layer closure. A possible mechanism of better wound healing in the former technique might be through decreased tissue handling and a reduction in leg edema.
Entities:
Keywords:
double layer closure; saphenous vein; single layer closure
Authors: M A Goldsborough; M H Miller; J Gibson; S Creighton-Kelly; C A Custer; J M Wallop; P S Greene Journal: Am J Crit Care Date: 1999-05 Impact factor: 2.228
Authors: Muhammed Zafar; Anil John; Zahid Khan; Simon M Allen; Adrian J Marchbank; C Terence Lewis; Malcolm J R Dalrymple-Hay; James Kuo; Jonathan Unsworth-White Journal: Ann Thorac Surg Date: 2005-12 Impact factor: 4.330
Authors: Bob Kiaii; Byung C Moon; David Massel; Yves Langlois; Thomas W Austin; Andrea Willoughby; C Guiraudon; Craig R Howard; L Ray Guo Journal: J Thorac Cardiovasc Surg Date: 2002-02 Impact factor: 5.209
Authors: J C Mullen; M J Bentley; K Mong; R Karmy-Jones; G Lemermeyer; E T Gelfand; A Koshal; D L Modry; P A Penkoske Journal: Can J Cardiol Date: 1999-01 Impact factor: 5.223
Authors: U P Schurr; M L Lachat; O Reuthebuch; A Kadner; M Mäder; B Seiffert; S P Hoerstrup; G Zünd; M Genoni; M I Turina Journal: Thorac Cardiovasc Surg Date: 2002-06 Impact factor: 1.827