A comparison of single-layer versus multi-layer closure of the leg wound following long saphenous vein harvest forcoronary artery bypass graft surgery: a prospective randomised controlled trial

Background and Cardiovascular diseases is the leading cause of death in the world. Over the last decades, open heart surgery reduced the mortality rate of these patients. The long saphenous vein is most commonly-used conduit in coronary artery bypass surgery. Complications associated with its harvest can lead to significant patient morbidity. We aimed to determine the optimal method of wound closure in these patients by comparing single-layer with multi-layer wound closure techniques. In a randomized controlled trial, eighty patients undergoing first-time elective coronary artery bypass were randomly divided into single-layer and multi-layer leg wound closure groups. In the first group, single-layer wound cloture technique, and in the second group, multiple-layer cloture technique was applied. Postoperative complications in both groups were analyzed using SPSS software (17) and descriptive statistical tests; t-test and chi-square. The two groups were comparable in respect of age, weight, height, sex and BMI. There was a significantly higher incidence of haematoma formation in the multi-layer closure group (n=18) compared with the single-layer closure group (n=5) (p<0.001). There was also a significantly higher incidence of saphenous nerve neuralgia in the multi-layer closure group on the 14th postoperative day. The incidence of postoperative pain and wound infection was also lower in the single-layer wound closure group. Single-layer leg wound closure following saphenous vein harvest for coronary artery bypass grafting is associated with fewer postoperative complications and does not impair postoperative wound-healing. We recommend its routine use in this clinical setting to prevent unwanted side effects such as wound infection and / or chronic pain and hematoma formation