Leg wound infection after coronary artery bypass grafting: A natural experiment comparing use and non-use of a compression stocking

Abstract

Background: Harvest site infections after coronary artery bypass grafting (CABG) are a known complication which represent a serious problem for patients and an increased cost of health care. There is a discrepancy in routine care regarding use of a graduated compression stocking on the leg with the saphenous vein harvest site. Some wards apply a compression stocking postoperatively to all in-hospital patients, others do not. The deep vein thrombosis prevention effect of compression stockings is well documented, but there are no studies of their possible preventive effect on harvest site infections. Aim: Our purpose was to examine whether the use of a graduated compression stocking for 4-6 weeks after CABG reduced the incidence of surgical wound infection at harvest sites. Methods: Data on 377 consecutive CABG patients (September 2011-December 2012) were collected from the hospital's patient registry and Surveillance System for Surgical Site Infections. Logistic regression was used to determine the odds of surgical site infection in patients at two surgical wards adhering to opposite practices regarding the use of compression stocking (stocking group n=296, no-stocking group n=155). Results: No significant relationship was found between post-operative infection rate and compression stocking routine. Conclusion: In this 'natural experiment' no evidence was found that the use of a graduated compression stocking reduced the incidence of harvest site surgical wound infection. As the treatment of most Norwegian CABG patients involves the use of a graft leg compression stocking, a randomised controlled trial (RCT) is called for to decide which treatment is better.