Wound healing complications at the saphenous vein harvest site after coronary artery bypass surgery

Coronary artery bypass grafting surgery is the most common cardiothoracic procedure worldwide, and postoperative wound healing complications in the leg harvest site are common. The overall aim of this thesis was to explore varied perspectives of leg wound infection with a focus on routines and methods, the patients’ experiences, and risk factors. In Study I, operating theatre nurses (n=62) and cardiac surgeons (n=56) from Swedish cardiothoracic centres (n=8) responded to a questionnaire regarding hygiene routines and surgical methods. The results indicate both similarities and differences between the centres. There is a lack of evidence regarding common routines and methods, and local routines might be one common factor. In Study II, interviews with patients (n=16) were performed to explore experiences of a serious wound healing complication. Pain, anxiety, and limitations in daily life affected the patients to varying degrees. Study III used local data from the Carath registry (n=2188) to explore risk factors for wound healing complications in the leg wound. Female sex, diabetes mellitus, higher body mass index, peripheral vascular disease, direct oral anticoagulants, and operation time ˃5 hours were detected as risk factors. In Study IV, follow-up data from patients (n=856) were investigated to identify risk factors for leg wound infection and other wound healing complications following coronary artery bypass surgery. Risk factors identified were female sex, vein harvesting technique, impaired left ventricle function, and the specific participating centres. In conclusion, female sex and the vein harvest technique may influence the risk of leg wound infection. Improved patient safety requires evidence-based routines, methods, and guidelines for healthcare professionals, as well as increased person-centred care.