# Effects of Harvesting Site and Incision Method on Surgical Wound Complications of No-Touch Saphenous Vein Grafts: A Retrospective Observational Study

## TL;DR

This study found that harvesting saphenous vein grafts from the upper leg and using skip incisions reduces wound complications compared to other methods.

## Contribution

The study introduces a modified no-touch harvesting method and identifies optimal sites and incision techniques to minimize wound complications.

## Key findings

- Wound complications were significantly lower in the upper leg compared to the lower leg.
- Skip incisions resulted in fewer wound complications than longitudinal incisions.

## Abstract

Saphenous vein grafts are frequently used for coronary artery
revascularization. However, harvesting veins is associated with infected
surgical sites and other complications. The no-touch technique that includes
harvesting saphenous vein grafts along with surrounding tissues improves
graft patency but increases the frequency of wound complications. We
harvested saphenous vein grafts using the no-touch technique and devised
other options for sites and incision methods to prevent wound complications.
This study aimed to determine the clinical outcomes of no-touch saphenous
vein grafts as well as associations between harvesting methods and wound
complications.

We enrolled 132 patients who underwent isolated coronary artery bypass
surgery with saphenous vein grafts harvested using the no-touch technique.
Wound condition, general status, and graft patency were assessed during
clinical follow-up.

We harvested 180 veins (lower legs, n = 69 veins; upper legs, n = 111) using
longitudinal and skip incisions at 100 and 80 sites, respectively. Wound
complications occurred at 35 sites. The frequency of complications was
significantly lower in the upper, than in the lower legs (14.4% vs. 27.5%).
Furthermore, wound complications were reduced more by skip, than by
longitudinal skin incisions (16.3% vs. 20.0%).

We devised a method to harvest no-touch saphenous vein grafts and determined
the clinical outcomes of saphenous vein grafts and harvesting sites.
Harvesting from the upper leg and via skip incisions reduced the frequency
of wound complications.