Surgical Wound Infection Clinical Trial
Official title:
An Investigation Into the Efficacy of Pre-operative Long Saphenous Vein Mapping Using Ultrasound for Use in Coronary Artery Bypass Grafting to Reduce Vein Harvest Site Complications.
The long saphenous vein is traditionally harvested for use as a conduit in coronary artery bypass grafting surgery. Currently, the long saphenous vein is not imaged prior to surgery. This study aims to evaluate preoperative ultrasound mapping of the long saphenous vein to to improve patient and clinical outcomes.
A vein from the leg is widely is widely harvested during coronary artery bypass grafting
(CABG) surgery for bypass of diseased coronary arteries. This vein is called the long
saphenous vein.
Currently, the long saphenous vein (LSV) is harvested blind by surgical practitioners with no
imaging prior to surgery to decide on whether this vein is suitable for use in heart bypass
surgery. This can result in fruitless incisions and result in additional unnecessary surgical
wounds in the leg(s) to identify a suitable section of vein that can be used in the bypass
operation. In these cases, excessive surgical trauma to the leg can increase the risk of a
wound infection.
There is some evidence that ultrasound imaging of the LSV improves leg wound outcomes in
patients having CABG surgery. Some studies have reported reductions in vein wound infection
rates, vein harvest time, length of hospitalisation and length of wounds.
The purpose of this study will be to investigate the potential benefit of ultrasound imaging
as a randomised control trial. One group will have ultrasound imaging of the long saphenous
vein prior to heart bypass surgery. A second group will not undergo ultrasound imaging which
is current practice at the Bristol Heart Institute.
Ultrasound imaging of the long saphenous vein will allow planning and selection of the most
optimal segment of vein. This targeted approach will allow guidance of surgical incisions
away from unsuitable segments and thus potentially improving leg wound outcomes.
The primary endpoint for this study will be to assess leg wound infection between the two
randomised groups. Other endpoints that will be assessed are patient satisfaction, wound
length, time taken to remove the vein, blood loss from the leg wound during surgery and the
number of wounds in your leg.
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