Objective

Conduit harvest site wound infection (HSWI) is a well-recognised complication following coronary artery bypass surgery (CABG). It is associated with considerable patient morbidity and economic burden in terms of increased length of stay, readmission rates and additional community service use. The primary aim of this study was to investigate whether the experience level of the operating surgeon was associated with the subsequent development of HSWI.

Methods

All patients undergoing saphenous vein harvest at a single institution between April 2011 and January 2015 were identified using the Recovery from Operation Quality Assessment System (ROQAS) database. This institutional database prospectively records a day by day account of a patient’s recovery from cardiac surgery. For each patient, the total number of harvest sites were recorded, graded anatomically and correlated with the operating surgeons training status and the incidence of HSWI.

Results

HSWI was found to be increased if performed by a consultant. Infection rates for consultants were 8.57%, compared to 1.89% for Trainees, defined as registrars, senior house officers or surgical care practitioners (p <0.05). Pre-operative factors associated with HSWI were increased age and BMI (p<0.005). Post-operatively, significant positive associations were found with prolonged ventilation, respiratory tract infection, sternal wound infection, arrhythmia, anaemia and renal dysfunction.

Conclusion

Increased harvest site wound infection was found to be significantly associated with consultant operator status.