MODIFIED METHOD FOR TAKING AUTO-VEIN BY “NO-TOUCH” METHODOLOGY

摘要

FIELD: medicine; cardiovascular surgery.;SUBSTANCE: large subcutaneous vein is isolated in a flap of soft tissues along its entire length without crossing a vein trunk. Then, it is removed from a wound cavity to the skin surface of the lower limb and covered with moistened napkins with a 2% papaverine solution. Subcutaneous adipose tissue is stitched with a continuous winding suture to the entire depth, leaving channels with a diameter of 30 mm at the exit of distal and entrance of proximal parts of the auto-vein trunk in a subcutaneous fat layer. Then, skin edges of the wound are immediately stitched together with a continuous intradermal suture, leaving unstitched areas 30 mm long at the exit and entrance points of the auto-vein trunk in the subcutaneous fat layer. Thus, auto-vein continues to be perfused with blood before anastomosing with coronary arteries, without hydraulic dilatations. As soon as the auto-vein is removed from the wound, skin edges left 30 mm unstitched are stitched with a continuous suture. ;EFFECT: method improves the healing of the postoperative wound of the lower limb and improves intraoperative local hemostasis.;1 cl, 1 dwg