Manifestation of cellulitis after saphenous venectomy for coronary bypass surgery

Abstract

A few cases of onset of cellulitis after saphenous venectomy for coronary by-pass surgery were first reported by Baddour and Bisno in 1982. We reviewed the clinical characteristics of 31 subjects followed up in our department following onset of manifestations of cellulitis after saphenous venectomy for coronary by-pass surgery. In all the subjects the cellulitis originated at the scar of the saphenous venectomy, and most presented ill-defined, mildly erythematous, slightly oedematous lesions. Mycologically confirmed tinea pedis was found in 25 subjects. All the patients responded well to penicillins or cephalosporins. In this report we comment on the pathogenesis of this complication of saphenous venectomy based on the clinical features of the cases reviewed. We suggest that saphenous venectomy may destroy the lymphatics in the lower leg, that are located adjacent to the great saphenous vein, and thus microorganisms penetrating into the skin may easily cause cellulitis in areas with impaired lymphatic drainage.