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Patients’ experiences regarding severe leg wound infection associated with coronary artery bypass grafting: A qualitative study
Örebro University, School of Health Sciences. Department of Vascular and Cardiothoracic Surgery, Örebro University Hospital, Örebro, Sweden.ORCID iD: 0000-0002-6122-9007
Örebro University, School of Health Sciences.ORCID iD: 0000-0003-0460-3864
Örebro University, School of Health Sciences.ORCID iD: 0000-0001-7862-3652
2023 (English)In: Journal of Vascular Nursing, ISSN 1062-0303, E-ISSN 1532-6578, Vol. 41, no 1, p. 12-18Article in journal (Refereed) Published
Abstract [en]

Introduction

Coronary artery bypass grafting (CABG) is the most common cardiac surgery throughout the world. The most commonly used graft is the saphenous vein. Wound healing complications related to saphenous vein harvesting are common, with reported surgical site infection rates ranging from 2% to 20%. Surgical site infection can be long-lasting, and the wound healing can be difficult and also presumably troublesome for the patient. CABG patients’ experiences of severe infection in the harvesting site have not been studied before.Aim: The aim of this study was to describe patients’ experiences associated with acquiring a severe infection in the harvesting site after CABG.

Method A qualitative study with descriptive design was conducted at the department of vascular and cardiothoracic surgery in a Swedish university hospital from May to December 2018. Patients diagnosed with a severe surgical site infection in the harvesting site following CABG were included. Data from 16 face-to-face interviews were analysed with inductive qualitative content analysis.

Result The main category, varying impact on body and mind, was the core of the patients’ experiences of severe wound infection in the harvesting site after CABG. Two generic categories were identified: physical impact and thoughts about the complication. The patients described experiencing different degrees of pain, anxiety, and limitation in daily life.

Conclusion These findings indicate that a severe infection in the harvesting site after CABG was experienced as an important issue with varying impact. Overall, the participants experienced pain, anxiety, and limitations in daily life. However, most of them were satisfied with the outcome after the wound had healed. Patients should be advised to seek care at an early stage if symptoms of infection occur. Improved individual pain management is needed for those with severe pain, and varied experiences imply a need for person-centred care.

Place, publisher, year, edition, pages
Elsevier, 2023. Vol. 41, no 1, p. 12-18
Keywords [en]
CABG, Content analysis, Experiences, Saphenous vein harvesting site, Surgical site infection, Wound healing
National Category
Nursing
Identifiers
URN: urn:nbn:se:oru:diva-103009DOI: 10.1016/j.jvn.2022.12.002ISI: 000957785500001PubMedID: 36898799Scopus ID: 2-s2.0-85145982550OAI: oai:DiVA.org:oru-103009DiVA, id: diva2:1725045
Funder
Örebro UniversityRegion Örebro CountyAvailable from: 2023-01-10 Created: 2023-01-10 Last updated: 2025-05-23Bibliographically approved
In thesis
1. Wound healing complications at the saphenous vein harvest site after coronary artery bypass surgery
Open this publication in new window or tab >>Wound healing complications at the saphenous vein harvest site after coronary artery bypass surgery
2025 (English)Doctoral thesis, comprehensive summary (Other academic)
Abstract [en]

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.

Place, publisher, year, edition, pages
Örebro: Örebro University, 2025. p. 93
Series
Örebro Studies in Medicine, ISSN 1652-4063 ; 329
Keywords
coronary artery bypass surgery, harvesting site, leg wound infection, patient safety, surgical site infection, wound healing complications
National Category
Other Health Sciences
Identifiers
urn:nbn:se:oru:diva-120073 (URN)9789175296715 (ISBN)9789175296722 (ISBN)
Public defence
2025-06-13, Örebro universitet, Campus USÖ, Tidefeltsalen, Södra Grev Rosengatan 32, Örebro, 09:00 (Swedish)
Opponent
Supervisors
Available from: 2025-03-20 Created: 2025-03-20 Last updated: 2025-06-11Bibliographically approved

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Larsson, HannaHälleberg Nyman, MariaFalk-Brynhildsen, Karin

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