When a bypass is done, veins are taken from other parts of the body (harvested) to replace the blocked arteries. You may have a bypass leg incision where the vein is taken from the leg (great saphenous vein) or it may be taken from the mammary arteries located near the collar bone. According to the Mayo Clinic Heart Book, the mammary arteries seem to stay open longer than the saphenous vein graphs.
Use of the great saphenous vein in the leg is often associated with complications in wound healing. In some cases it can also have poor cosmetic results and delay the patient's return to activity.
When the great saphenous vein is used, a long, continuous incision that begins at the ankle and ends at the knee or even the mid thigh is the traditional technique for coronary artery bypass. If multiple bypasses are being done, you may have veins taken from both legs.
With the traditional bypass leg incision technique, wound-healing disorders are common, the wound can take a long time to heal, and the scar is larger. Some people report pain on movement of the leg during the healing process. Most patients with leg-wound complications are treated with antibiotics as outpatients or by a visiting nurse. In some cases people require readmission for intravenous antibiotics and further surgery.
An alternative technique for saphenous vein removal is to have three small incisions through which the vein is harvested. This means you will have smaller wounds and less scarring. As with the traditional method, you will have drainage tubes and an elastic bandage while you are in hospital. The elastic bandage is to prevent swelling and for your comfort.
Some patients report swelling, numbness, and tingling in their leg(s) during the recovery period. Smoking, advanced age, and diabetes can negatively impact successful wound healing. In some cases the wound can take quite a while to heal.
If you are going to run into leg wound problems, it's most often around the seventh day after your operation.
Care of leg incision following bypass
After you come home from the hospital, follow instructions provided by your doctor or hospital staff.
You may go home with staples in your bypass leg incision. If you have a visiting nurse, the nurse will take the staples out as directed by your doctor.
Check your incision(s) every day. Notify your doctor if you notice any of the following: