Comparison between Single Layer Interrupted and Double Layer Continuous Closure of Leg Wound after Great Saphenous Vein Harvest in Coronary Artery Bypass Grafting

Abstract

Background: Great saphenous vein is a popular conduit for coronary artery bypass graft. But the harvest site wound infection increases morbidity and prolong hospital stay. Closing techniques of saphenectony wound may contribute to early post operative outcome of the patient. The purpose of this study was to compare outcomes of the different closing techniques of saphenectomy wound.

Methods: This comparative cross-sectional study was carried out with 58 patients who underwent coronary artery bypass graft (CABG) and great saphenous vein was harvested as a conduit. Out of which 29 patients underwent single layer (Group-A) and rest 29 patients underwent double layer closure (Group-B) of saphenectony wound. Incidence of wound complications was compared between the two groups.

Results: On analysis of age, sex, weight, comorbidities and per operative variables, no significant differences were observed between two groups. There was significant statistical difference of mean ASEPSIS score (p=0.011) between the group A (4.17±5.9) and group B (9.55±9.44). Serous discharge was noted in 4 (13.8%) patients in group A and 10 (34.5%) patients in group B. Four (13.8%) patients had erythema in group A and 11 (37.9%) in group B. Four (13.8%) patients had purulent exudates in group A and 1 (3.4%) in group B. Three (10.7%) patients had edema in group A and 10 (34.5%) in group B. The differences of erythema and edema were statistically significant (p<0.05) between two groups. Almost three fourth (72.4%) of patients had satisfactory healing in group A and 12 (41.4%) in group B. No patient had severe wound infection.               

Conclusion: Single layer interrupted closure had shown an overall improved wound outcome and less pain compared to double layer closing technique in terms of erythema, edema and satisfactory wound healing.

Cardiovasc j 2024; 17(1): 5-11