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Ann Thorac Surg 2003;75:101-105
© 2003 The Society of Thoracic Surgeons

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Original article: cardiovascular

Occlusive wrap dressing reduces infection rate in saphenous vein harvest site

^a Cardiac Surgical Research Unit, Department of Cardiothoracic Surgery, Alfred Hospital, Melbourne, Australia
^b Cardiac Surgical Research Unit, Department of Vascular Surgery, Alfred Hospital, Melbourne, Victoria, Australia

Accepted for publication July 30, 2002.

* Address reprint requests to Dr Rosenfeldt, Department of Cardiothoracic Surgery, Alfred Hospital, Commercial Rd, Prahran 3181, Melbourne, Victoria, Australia.
e-mail: f.rosenfeldt{at}alfred.org.au

BACKGROUND: Infection in the saphenous vein harvest site is a common problem. We developed an occlusive circumferential wrap dressing technique that reduces skin edge tension, eliminates dead space, and prevents external contamination. We compared the surgical site infection rate using the wrap dressing technique with that of standard longitudinal dressings.

METHODS: One hundred fifty-two consecutive patients were randomly assigned to receive either standard dressings or the wrap dressing. Data were collected in the hospital and then 4 to 6 weeks postoperatively. Superficial and deep wound infections were defined by the standard criteria from the Centers for Disease Control and Prevention.

RESULTS: The infection rate in the wrap group was 14% compared with 35%, for the standard group (p = 0.006). Multivariate analysis showed that wrap technique was the only significant predictor (negative) of infection (odds ratio, 0.19; p = 0.001).

CONCLUSIONS: In saphenous vein harvest wounds, the occlusive wrap dressing technique has the potential to reduce the rate of infection by 50%. This simple and inexpensive technique is also readily applicable to the radial artery harvest site in the arm and may provide similar benefit.

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