Unilayer Closure of Saphenous Vein Incision Lines is Better than Bilayer Closure

Osman Tiryakioglu1, *, Tugrul Goncu1, Gunduz Yumun1, Onder Bozkurt1, Ahmet Demir1, Selma Kenar Tiryakioglu2, Ahmet Ozyazicioglu1, Senol Yavuz 1
1 Bursa Yuksek İhtisas Education and Research Hospital, Department of Cardiovascular Surgery, Bursa, Turkey
2 Mehmet Akif Ersoy Thoracic and Cardiovascular Surgery Education and Research Hospital, Department of Cardiology, İstanbul, Turkey

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© Tiryakioglu et al.; Licensee Bentham Open.

open-access license: This is an open access article licensed under the terms of the Creative Commons Attribution Non-Commercial License ( which permits unrestricted, non-commercial use, distribution and reproduction in any medium, provided the work is properly cited.

* Address correspondence to this author at the Bursa Yuksek İhtisas Hastanesi Prof. Tezok cad. No:1 16320 Yildirim, Bursa, Turkey; Tel: +902243605050; Fax: +902243605055; E-mail:



To examine early results in patients with incision lines closed only along the skin and subcutaneous tissue after removal of the great saphenous vein during coronary artery bypass surgery.

Materials and Methods:

We enrolled 82 patients who underwent elective operations in our clinic between December 2008 and April 2009. The patients had similar demographic characteristics, and the method of incision closure was chosen randomly. Three patients were excluded due to in-hospital mortality. The saphenous incision lines were closed using continuous skin sutures in 41 patients (Group 1) or using continuous subcutaneous sutures followed by continuous skin sutures in 38 patients (Group 2). Patients were followed every day that they were in the hospital, in the first week after being discharged, and at the end of the second month after discharge. The incision lines were evaluated for hematomas, infection, edema, pain and numbness.


During the follow-up performed in-hospital and in the first week after discharge, infection, edema and numbness were observed significantly more often in Group 2 than in Group 1. Hematoma was observed more often in Group 1, and pain was observed more often in Group 2, but neither of these findings reached statistical significance. During the follow-up at the end of the second month after discharge, infection, edema, and numbness were observed significantly more frequently in Group 2.


In patients undergoing saphenous removal using standard procedures, it is sufficient to close the incision line using only skin sutures.

Keywords: Saphenous vein graft, subcutaneous closure, coronary bypass surgery..