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,1,2 Bing-Jie Wang,3 Jiang Liu,1 Chu Liu,1 Ji-Qiang Bu,1 Yu Liu,1 Fang Yan,1 Wen-Li Zhang,1 Zi-Ying Chen,1 Yu-Ming Wu2 1Department of Cardiac Surgery, The Second Hospital of Hebei Medical University, Shijiazhuang, 050000, People’s Republic of China; 2Department of Physiology, Hebei Medical University, Shijiazhuang, 050000, People’s Republic of China; 3Department of Anesthesiology, The Third Hospital of Hebei Medical University, Shijiazhuang, 050000, People’s Republic of ChinaCorrespondence: Zi-Ying Chen, Department of Cardiac Surgery, The Second Hospital of Hebei Medical University, No. 215 of Heping West Road, Xinhua District, Shijiazhuang, 050000, People’s Republic of China, Tel +86 15803210520, Email ziyingchenorg@126.com Yu-Ming Wu, Department of Physiology, Hebei Medical University, No. 361 of Zhong Shan East Road, Shijiazhuang, 050017, People’s Republic of China, Tel +8631186261288, Email wuym@hebmu.edu.cnObjective: 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