A review of the best method of leg wound closure following open harvesting of the long saphenous vein for coronary artery bypass grafting. (October 2021)

• Record Type: Journal Article
• Authors: Panahi, Pedram; Ilyas, Ali Adeeb; Lloyd, Clinton; Marchbank, Adrian; Unsworth-White, Jonathan
• Is Part Of: Annals of medicine and surgery. Volume 70(2021)
• Publication Date: 2021-10
• Subjects: Evidence-based medicine -- Coronary artery bypass graft -- Coronary revascularization -- Long saphenous vein -- Great saphenous vein -- Closure method -- Single layer closure -- Double layer closure -- Multiple layer closure; Surgery -- Periodicals; Medicine -- Periodicals; General Surgery -- Periodicals; Education, Medical -- Periodicals; Periodicals; 617
• DOI: 10.1016/j.amsu.2021.102855
• Languages: English
• ISSNs: 2049-0801

Abstract

Abstract: Uncertainty exists around the optimal method of leg wound closure following open long saphenous vein harvesting in adults undergoing coronary artery bypass graft surgery (CABG). Such is evident from the variety observed in the closure approach utilised. Consequently, a best evidence topic in cardiac surgery was written according to a structured protocol. The question addressed was 'following open long saphenous vein harvesting in adults undergoing CABG, is single-layer leg wound closure superior to multiple-layer closure in terms of post-operative complications encountered? '. Altogether 382 papers on Ovid Embase and Ovid Medline, 301 papers on PubMed and 11 papers on the Cochrane database were found using the reported search. From the screened articles, 6 represented the best evidence to answer the clinical question. The authors, journal, date and country of publication, patient group studied, study type, relevant outcomes and results of these papers are tabulated. We conclude that the best method of leg closure following open saphenous vein harvesting for CABG is single-layer cutaneous closure. The use of a suction drain to eliminate the dead space should be considered on a case-to-case basis by the lead operating surgeon with the patient's characteristics and their own expertise in mind. Highlights: Uncertainty exists around the best closure method after open harvesting of the long saphenous vein for CABG in adults. Various options include single-layer and multiple-layer closure. Therefore, we conducted a literature review to identify the best closure technique. We conclude that the best method is single-layer cutaneous closure. The use of a suction drain to eliminate the dead space should be considered.