Post harvest wound infection and patient s perception: comparative study between radial artery and saphenous vein harvest sites.

Abstract:  INTRODUCTION: Despite renewed clinical interest in radial artery grafts (RA) for coronary artery bypass grafting, there is a paucity of controlled prospective data on its efficacy. We report on the rate of harvest related complications from a randomized radial artery study. METHODS: Two hundred eighty nine patients were divided into two groups. Group 1 received RA grafts (n=154 patients) and Group 2 (n=135 patients) received saphenous vein grafts (SVG). Postoperative wound problems were assessed using a questionnaire. Postoperative harvest site infections were also carefully documented. RESULTS: In group 1, 6 of 154 (3.9%) patients had harvest site wound infections. Five of them improved by antibiotic therapy alone. In group 2, 24 of 135 (17.8%) patients had harvest site wound infections (p=0.001 vs. group 1). Fifteen of these patients needed redressing due to discharge from the wound. One hundred forty-nine patients (96.7%) in group 1 answered that their hand function was normal on the questionnaire. Concerns and discomfort about the arm scars in the group 1 were of a similar value of 5.2% (8/154), respectively. In group 2, the incidence of those about the leg were 7.4% (10/135) and 11.9% (16/135), respectively. Although there was no significant difference in concerns about the scar, discomfort was significantly higher in group 2 compared with group 1 (p=0.0139). CONCLUSIONS: RA harvest is associated with fewer wound infections and scar discomfort than SVG harvest. Radial artery harvest is almost acceptable in terms of a patient's perception. However, there are still patients who have some symptoms in the forearm after RA harvest. Long-term follow-up is necessary for patient's hand function.