Optimizing Saphenous Vein Harvest Site Closure: A Comparison of PRINEO and Traditional Staples in CABG Patients

Background Complications at the saphenous vein harvest site, including surgical site infection, wound dehiscence and prolonged drainage, remain underexplored in cardiac surgery despite their impact on recovery, length of hospital stay and healthcare costs. Up to 24% of patients undergoing coronary artery bypass grafting (CABG) experience such complications. Skin closure of vein harvest sites is traditionally performed using skin staples. Alternative closure systems such as PRINEO combine an adhesive layer with a reinforcing mesh designed to support wound edge approximation and protection. Aims To compare postoperative outcomes of saphenous vein harvest site closure using traditional skin staples versus the PRINEO adhesive mesh system in patients undergoing CABG. Methods This retrospective single centre cohort study included adult patients undergoing CABG with saphenous vein grafts between January 2018 and October 2024. Patients receiving exclusively arterial grafts were excluded. Patients were grouped according to harvest site closure technique: staples or PRINEO. Primary outcomes were local complications including surgical site infection, wound dehiscence and prolonged drainage. Secondary outcomes included length of hospital stay, need for reintervention and 30 day mortality. Results A total of 747 patients were included. Mean age was 62.4 years and 83.4% were male. Preoperative risk factors and operative variables were comparable between groups. Surgical site infection occurred in 3.58% of patients in the PRINEO group and 12% in the staple group (P<0.01). Wound dehiscence or prolonged drainage occurred in 5% versus 20%, respectively (P<0.01). Thirty day mortality did not differ. Length of hospital stay was shorter in the PRINEO group. Conclusion In this cohort, PRINEO was associated with fewer local wound complications and shorter hospital stay compared with staple closure. Prospective studies are warranted to confirm these findings.