Postoperative Complications Clinical Trial
Official title:
Acupuncture and Post-Surgical Wound Healing in Coronary Artery Bypass Graft Patients Undergoing Open Saphenous Vein Graft Harvest
The purpose of this study is to determine if acupuncture improves wound healing. Since we, the investigators at the University of California, San Francisco (UCSF), know that how much oxygen is delivered to tissue is the best predictor of how well a wound will heal, we are measuring changes in tissue oxygen of wounds before and after acupuncture treatments. We are focusing on the leg wounds of coronary artery bypass graft (CABG) patients who have their saphenous veins harvested in an open fashion since this is a fairly well controlled patient model.
This is a prospective, randomized, controlled pilot study of the effects of acupuncture on
surgical site complications in patients undergoing coronary artery bypass grafting. The past
forty years of research in the UCSF Wound Healing Laboratory have solidified the following
observations:
1. without adequate oxygen delivery, many processes of wound healing cannot proceed
normally, particularly resistance to infection, collagen deposition, angiogenesis, and
inflammation; and
2. hypoxic conditions, unfortunately, are common in chronic and acute wounds, and often
result from subcutaneous vasoconstriction.
Sympathetic nervous system (SNS) activators and other vasoconstrictors have been shown to
produce wound hypoxia. Activation of the SNS by any means, including pain and anxiety,
causes vasoconstriction and impairs oxygen delivery. Simple means that limit SNS activity
have been shown to increase perfusion and oxygen tension, and thereby facilitate wound
healing. Many preliminary studies have shown that acupuncture decreases SNS activation,
pain, and anxiety. In addition, there is evidence that acupuncture enhances circulation of
blood. We therefore hypothesize that acupuncture will facilitate wound healing. We aim to
quantify changes in anxiety, pain, stress hormones, and perfusion and oxygenation induced by
these interventions, as well as wound healing outcomes, including infection and other wound
complications.
;
Allocation: Randomized, Endpoint Classification: Safety/Efficacy Study, Intervention Model: Parallel Assignment, Masking: Double Blind (Subject, Caregiver, Investigator, Outcomes Assessor), Primary Purpose: Prevention
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