Page 74 - Virtual Vascular Vol 15

Scenarios in a femoral-popliteal bypass with
long saphenous vein graft – what should we
use?

• During the harvest of the long saphenous vein, its
branches must be ligated
• A non-absorbable material should be used to
prevent leakage over time, e.g. 4-0 Silk
• During popliteal artery-vein anastomosis
• A non-absorbable material should be used e.g.
Prolene, to prevent anastomotic leak
• 6-0 is an appropriate size for a distal vessel; if the
anastomosis involves the aorta in an open AAA
repair, a large suture such as 3-0 Prolene would
be more appropriate
• During wound closure
• Approximation of subcutaneous layers requires
running sutures where the knot will be buried in
tissue -> absorbable material such as Vicryl should
be used
• Skin closure -> Nylon or monocryl is strong
enough for a wound in the leg; a wound in the
face may warrant the use of 5-0 or 6-0 sutures for
better cosmetic outcome

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