Improved Technique Reduce Lower Limb Complications After the Traditional No-Touch Technique for Vein Graft Harvesting: A Single-Center Retrospective Historical Controlled Study

Teng-Yue Zhao; Bing-Jie Wang; Jiang Liu; Chu Liu; Ji-Qiang Bu; Yu Liu; Fang Yan; Wen-Li Zhang; Zi-Ying Chen; Yu-Ming Wu

doi:10.2147/JMDH.S492144

Improved Technique Reduce Lower Limb Complications After the Traditional No-Touch Technique for Vein Graft Harvesting: A Single-Center Retrospective Historical Controlled Study

J Multidiscip Healthc. 2024 Nov 20:17:5435-5444. doi: 10.2147/JMDH.S492144. eCollection 2024.

Authors

Teng-Yue Zhao^{1

2}, Bing-Jie Wang³, Jiang Liu¹, Chu Liu¹, Ji-Qiang Bu¹, Yu Liu¹, Fang Yan¹, Wen-Li Zhang¹, Zi-Ying Chen¹, Yu-Ming Wu²

Affiliations

¹ Department of Cardiac Surgery, The Second Hospital of Hebei Medical University, Shijiazhuang, 050000, People's Republic of China.
² Department of Physiology, Hebei Medical University, Shijiazhuang, 050000, People's Republic of China.
³ Department of Anesthesiology, The Third Hospital of Hebei Medical University, Shijiazhuang, 050000, People's Republic of China.

Abstract

Objective: The employment of the no-touch technique in harvesting the great saphenous vein (GSV) for coronary artery bypass grafting has been associated with a significant improvement in clinical patency rates. Despite these advantages, such grafts may predispose patients to complications in the lower limbs. This study endeavors to evaluate the incidence of complications in the lower extremities by deploying an enhanced protocol for the no-touch harvesting technique.

Methods: The historical control group in this study included patients who underwent coronary artery bypass grafting (CABG) with the no-touch technique for GSV harvesting at our institution from August 2018 to April 2020, in compliance with ethical standards. The intervention group consisted of patients who received CABG and were subjected to an optimized no-touch technique for GSV harvesting from May 2020 to June 2022. Technical modifications were applied to reduce lower limb complications, including limited use of electrocautery, minimization of extravascular tissue preservation, relaxation of postoperative elastic compression bandages, and elevation of the lower extremities. These measures aimed to decrease the incidence of postoperative lower limb complications, such as pain, numbness, edema, exudation, and delayed healing. The occurrences of postoperative complications were meticulously documented, compared, and analyzed between the two groups.

Results: The adoption of the optimized no-touch technique resulted in a significant decrease in the incidence of postoperative lower extremity incisional complications among patients subjected to off-pump CABG (p < 0.05).

Conclusion: The results of this study substantiate that the application of an optimized no-touch technique to harvest the GSV significantly diminishes the incidence of postoperative lower limb complications in patients receiving CABG. These results highlight the importance of adopting and integrating this optimized technique into clinical protocols, emphasizing its critical role in advancing patient care outcomes.

Keywords: historical controlled study; lower limb complications; no-touch great saphenous vein; off-pump coronary artery bypass grafting; propensity score matching.

Grants and funding

1. Hebei Provincial Department of Finance Government Funding for Public hospital reform and high-quality development demonstration project (No.36); 2. Hebei Provincial Department of Finance Government Funding for Specialty Capacity Building and Specialty Leader Train (No. 303-2022-27-07).