Bypass leg incision

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Bypass leg incision - complications are not uncommon

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 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 leg. 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:

Increased tenderness

Increased redness or swelling around the edges of the incision line

Drainage from the incision line

Persistent or high fever

Other considerations

Avoid crossing your legs because this can impair circulation.

Avoid sitting in one position for long periods of time.

Avoid standing for long periods of time.

Elevate your leg on a stool when sitting or stretch out on a couch.

Check your leg(s) for swelling each day. Swelling should decrease when you elevate your leg, but it might be noticeable when you stand. If you continue to have leg swelling or if it becomes worse, call your doctor.

Elastic Stockings

If you were prescribed to wear elastic stockings, wear them during the day as directed. The stockings can help decrease swelling. Remove your stockings when you go to bed.

The scar will heal

Protect your incision(s) from over exposure to sunlight during the first year after surgery. The scar will be darker if it is exposed to sun. Do not apply any medications to your incision(s), unless prescribed by your doctor or okayed by your visiting nurse.

It may take some time, but your leg(s) will heal over time. Just be sure to report any complications or concerns to your doctor and seek medical treatment.

Have you experienced complications or problems with your leg wound? Send us your story.

Sources:
European Journal of Cardio-Thoracic Surgery, Volume 23, Issue 6, June 2003
The Society of Thoracic Surgeons
Mayo Clinic Heart Book

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