نقش فاكتورهاي موثر در پيدايش عوارض اندام تحتاني بعد از برداشت وريد صافن در عمل جراحي گرافت شريان كرونري

Major Leg Wound Complications After Saphenous Vein Harvest for Coronary Revascularization

Background: Major leg wound complications after coronary artery bypass graft procedures are infrequent and few are reported in the litrature.We present our experience in treating 30 patients with major leg wound complications after coronary revascularization procedures. Materials and Methods: A retrospective review of 2100 bypass procedures with saphenous veingraft performed over a 5-years period was conducted.!5 potential risk factors for those who developed Major leg wound complications were analyzed and compared with the entire cohort of patients undergoing similar bypass procedures during the same period. Results: lower extremity wound complications occurred in 30 patients (1.4%),l g of whom required additional surgical interventions.There were 6 wound debridments 2 skin grafts, l angioplasty, 7fasciotomies, l embolectomy and fasciotomy 2 free tissue transfer. Of 14 variables evaluated by multivriate analysis, cardiopulmonary bypass time, duration of surgery and postoperative intraaortic ballon pump use were identified as significant independent predictors of major leg wound complications (p<0.05). Conclusion: The causes of major leg wound complications after saphenous vein harvest for coronary artery bypass graft procedures are multifactorial. To minimize these complications,we recommend vascular evaluations before saphenous vein harvest, attention to proper surgical tecnique,and careful harvest site selection.