Title

Multiple skip incisions vs single long incision for single stage basilic transposition arteriovenous fistula: a cohort study

Document Type

Article

Department

Surgery; General Surgery

Abstract

Introduction: Basilic vein transposition via single long incision is a renowned technique despite its known wound related complications. Contrary to that, multiple skip incisions technique is thought to have relatively lower wound related complications. But to the best of our knowledge these two techniques have never been formally compared. So we conducted this study to compare both.

Material & Methods: This was a retrospective cohort study. Patients who underwent basilic vein transposition arteriovenous fistula (AVF) from January 2011 till May 2016 at Aga Khan University hospital, Pakistan were eligible for inclusion in the study. Study population was divided into two groups; one group comprising of patients who underwent fistula formation through single long incision and the other group had the procedure done via multiple skip incisions. Wound related complications including wound infection and dehiscence, fistula maturation time, duration of surgery and primary patency at a follow up of 12 months were recorded.

Results: Both the groups were comparable regarding baseline variables. Incidence proportion of wound infection, hematoma and dehiscence was higher in long incision group, however it was statistically insignificant. Primary patency at 12 months in skip vs long incision group was 73.0% vs. 69.7% (p-value: 0.62). The Mean maturation time for fistula was 42.8 +/- 9.5 days and 44.3 +/- 10.4 days in Skip and Long incision group respectively(p-value :0.31). Duration of surgery was comparable in both.

CONCLUSION: Although skip technique does not have significant benefit over long incision technique based on these results, but it is a valid alternative. RCT is required to better differentiate between these two.

Publication

Annals of Vascular Surgery

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