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Willard M. Daggett
David F. Torchiana
Cary W. Akins
Gus J. Vlahakes
Joren C. Madsen
Thomas E. MacGillivray
Arvind K. Agnihotri
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Ann Thorac Surg 2002;73:523-528
© 2002 The Society of Thoracic Surgeons

Original article: cardiovascular

Endoscopic versus open saphenous vein harvest: a comparison of postoperative wound complications

Jerene M. Bitondo, PACa, Willard M. Daggett, MDa, David F. Torchiana, MD*a, Cary W. Akins, MDa, Alan D. Hilgenberg, MDa, Gus J. Vlahakes, MDa, Joren C. Madsen, MDa, Thomas E. MacGillivray, MDa, Arvind K. Agnihotri, MDa

a Division of Cardiac Surgery, Massachusetts General Hospital, Boston, Massachusetts, USA

Accepted for publication September 21, 2001.

* Address reprint requests to Dr Torchiana, Division of Cardiac Surgery, Massachusetts General Hospital, Bulfinch 119, 55 Fruit St, Boston, MA 02114, USA
e-mail: dtorchiana{at}partners.org

Background. Wound complications associated with long incisions used to harvest the greater saphenous vein are well documented. Recent reports suggest that techniques of endoscopic vein harvest may result in decreased wound complications. A prospective, nonrandomized study was developed to compare outcomes of open versus endoscopic vein harvest procedures.

Methods. There were 106 patients in the open vein harvest group, and 154 patients in the endoscopic vein harvest group. Patient characteristics and demographics were similar in both groups. Wound complications identified were dehiscence, drainage for greater than 2 weeks postoperatively, cellulitis, hematoma, and seroma/lymphocele.

Results. Wound complications were significantly less in the endoscopic vein harvest group (9 of 133, 6.8%) versus the open vein harvest group (26 of 92, 28.3%), p less than 0.001. By multivariable analysis with logistic regression, the open vein harvest technique was the only risk factor for postoperative leg wound complication (relative risk 4.0).

Conclusions. Endoscopic vein harvest offered improved patient outcomes in terms of wound healing compared with the open vein harvest technique.




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