Background
Methods
Study design and setting
Questionnaires
Participants
Ethical considerations
Statistical analysis
Results
Perioperative routines
Variable | OT nurses (N = 62) |
---|---|
Place of preparing equipment and surgical instruments, n (%) | |
In the preparation room | 11 (17.7) |
In the OT | 51 (82.3) |
The sterile table is covered preoperatively, n (%) | |
Yes | 59 (95.2) |
No | 3 (4.8) |
Time of preparing equipment and surgical instruments, n (%) | |
Before the patient arrives in the OT | 56 (90.3) |
When the patient is being prepared in the OT | 6 (9.7) |
Separate table for instruments used in the vein harvesting, n (%) | |
Yes | 47 (75.8) |
No | 15 (24.2) |
Separate instruments used in the vein harvesting, n (%) | |
Yes | 58 (93.5) |
No | 4 (6.5) |
Skin disinfection, n (%) | |
OT nurse | 60 (96.8) |
Surgeon | 1 (1.6) |
Assistant | 1 (1.6) |
Skin disinfection solution, n (%) | |
Chlorhexidine 5 mg/ml in 70% ethanol | 62 (100) |
Ethanol 70% | 0 (0) |
Iodine | 0 (0) |
Chloraprep 2% | 0 (0) |
Estimated time for skin disinfection of leg, n (%) | |
1–3 min | 18 (29.0) |
3–5 min | 36 (58.1) |
5–10 min | 8 (12.9) |
Tinted skin disinfection solution, n (%)a | |
Yes | 39 (62.9) |
No | 21 (33.9) |
Skin disinfection of both legs, n (%) | |
Yes | 44 (71.0) |
No | 18 (29.0) |
Leg lift for skin disinfection, n (%) | |
Manually by staff | 53 (85.5) |
Leg lift device | 9 (14.5) |
Incision film on the leg/legs, n (%) | |
Always/almost always | 0 (0) |
Always/almost always on any damaged skin on the leg | 1 (1.6) |
Sometimes | 0 (0) |
Never/almost never | 61 (98.4) |
Incision film with iodine, n (%) | |
Yes | 9 (14.5) |
No | 12 (19.4) |
Never use incision film | 41 (66.1) |
Integuseal on the leg/legs, n (%)a | |
Always/almost always | 0 (0) |
Sometimes | 1 (1.6) |
Never/almost never | 58 (93.5) |
Non-operated leg is covered, n (%)a | |
Always/almost always | 42 (67.7) |
Sometimes | 12 (19.4) |
Never/almost never | 6 (9.7) |
Vein harvesting begins before the patient is totally draped for the heart surgery, n (%)a | |
Always/almost always | 10 (16.1) |
Sometimes | 10 (16.1) |
Never/almost never | 41 (66.1) |
Variable | OT nurses (N = 62) |
---|---|
Gloves changed after vein harvesting, n (%) | |
Always/almost always | 61 (98.4) |
Sometimes | 1 (1.6) |
Never/almost never | 0 (0) |
Elastic bandage used intraoperatively, n (%)a | |
Always/almost always | 59 (95.2) |
Sometimes | 1 (1.6) |
Never/almost never | 0 (0) |
Position changes used to avoid pressure damage, n (%)a | |
Always/almost always | 2 (3.2) |
Sometimes | 16 (25.8) |
Never/almost never | 43 (69.4) |
Bleeding control of the leg wound during ECCb, n (%) | |
Yes | 19 (30.6) |
No | 43 (69.4) |
Suturing the leg/legs, n (%) | |
Attending in cardiothoracic surgery | 6 (9.7) |
Resident in cardiothoracic surgery | 13 (21.0) |
Intern | 29 (46.8) |
OR nurse | 4 (6.5) |
Other | 10 (16.0) |
Drain to the leg, n (%) | |
Always/almost always | 0 (0) |
Sometimes | 11 (17.7) |
Never/almost never | 51 (82.3) |
Clots and blood removed before dressing, n (%) | |
Always/almost always | 59 (95.2) |
Sometimes | 3 (4.8) |
Never/almost never | 0 (0) |
Cleaning solution before dressing, n (%) | |
Sodium chloride | 2 (3,2) |
Chlorhexidine 5 mg/ml in 70% ethanol | 43 (69.4) |
Other chlorhexidine solutions | 17 (27.4) |
Semipermeable dressing on the leg/legs, n (%)a | |
Always/almost always | 32 (51.6) |
Sometimes | 0 (0) |
Never/almost never | 26 (41.9) |
Nonpermeable dressing on the leg/legs, n (%)a | |
Always/almost always | 28 (45.2) |
Sometimes | 3 (4.8) |
Never/almost never | 28 (45.2) |
Dressing application on the leg/legs, n (%) | |
Attending in cardiothoracic surgery | 1 (1.6) |
Resident in cardiothoracic surgery | 3 (4.8) |
Intern | 7 (11.3) |
OR nurse | 50 (80.6) |
Other | 1 (1.6) |
Elastic bandage used after the leg wound is dressed, n (%)a | |
Always/almost always | 56 (90.3) |
Sometimes | 3 (4.8) |
Never/almost never | 2 (3.2) |
Compression stocking used after the leg wound is dressed, n (%)a | |
Always/almost always | 11 (17.7) |
Sometimes | 0 (0) |
Never/almost never | 50 (80.6) |
Leg compression, n (%)a | |
Lower limb | 20 (32.3) |
Whole leg | 41 (66.1) |
No compression | 0 (0) |
Surgical methods
Variable | Cardiothoracic surgeon (N = 56) |
---|---|
Own frequency of SVH, n (%) | |
> 20 times/year | 32 (57.1) |
11–20 times/year | 12 (21.4) |
6–10 times/year | 5 (8.9) |
1–5 times/year | 5 (8.9) |
Never | 2 (3.6) |
Vein harvester, n (%) | |
Attending in cardiothoracic surgery | 17 (30.4) |
Resident in cardiothoracic surgery | 16 (28.6) |
Operating theatre nurse | 5 (8.9) |
Intern | 14 (25.0) |
Operations assistant | 1 (1.8) |
Vein harvester | 2 (3.6) |
Common clinical technique for SVH, n (%) | |
Yes | 12 (21.4) |
Partly | 35 (62.5) |
No | 7 (12.5) |
Type of vein graft, n (%)a | |
Conventional | 44 (78.6) |
“No-touch” | 17 (30.4) |
Endoscopic | 0 (0) |
Ligation of side branches, n (%) a | |
Clips | 34 (60.7) |
Absorbable ligature | 18 (32.1) |
Non-absorbable ligature | 27 (48.2) |
Other | 1 (1.8) |
Diathermy/coagulation, n (%) | |
Monopolar diathermy | 40 (71.4) |
Bipolar diathermy | 10 (17.9) |
Ultrasound “harmonic scalpel” | 1 (1.8) |
Never use diathermy | 3 (5.4) |
Suturing the leg/legs, n (%) | |
Attending in cardiothoracic surgery | 13 (23.2) |
Resident in cardiothoracic surgery | 11 (19.6) |
Operating room nurse | 4 (7.1) |
Intern | 23 (41.1) |
Operations assistant | 1 (1.8) |
Vein harvester | 2 (3.6) |
Skin suture, n (%) | |
Intracutaneous suture | 54 (96.4) |
Skin staples | 0 (0) |
Suture layers in subcutis, n (%) | |
One layer | 23 (41.1) |
Two layer | 9 (16.1) |
No subcutaneous layer | 22 (39.3) |
Subcutaneous suture, n (%) | |
Braided | 23 (41.1) |
Monofilament | 24 (42.9) |
No subcutaneous suture | 9 (16.1) |
Intracutaneous suture, n (%) | |
Braided | 4 (7.1) |
Monofilament | 50 (89.3) |
Suture with triclosan (Vicryl+), n (%) | |
Always | 23 (41.1) |
Sometimes | 9 (16.1) |
Never | 22 (39.3) |