The neglected second wound: a qualitative study of patients’ experiences of lower limb vascular harvesting for coronary artery bypass grafting

Q: What is the clinical evidence from this study?

Population: Coronary artery bypass grafting (CABG) with saphenous vein harvesting (n=23). Intervention: Lower limb vein harvesting for CABG. Primary outcome: Patients' experiences and feelings regarding lower limb vein harvesting.

Q: What does this research mean for the field?

Patients undergoing coronary artery bypass grafting with lower limb vein harvesting experience preoperative cognitive differences influencing decision-making, postoperative psychological distress driven by physiological changes, and a need for body image reconstruction. Novelty: ClaimNovelty.INCREMENTAL. Consensus alignment: ConsensusAlignment.NEUTRAL.

Si-Yu Liu; Fei Li; Yu-Hong Chen; Shan-Shan Liu; Xiao-Min Zhang; Guo-Zhen Sun

doi:10.1136/bmjopen-2025-110448

July 1, 2026BMJ OpenOpen Access

The neglected second wound: a qualitative study of patients’ experiences of lower limb vascular harvesting for coronary artery bypass grafting

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Key result

Lower limb vein harvesting in CABG triggers substantial postoperative psychological distress and body image disruption.

n=23

Why the study?

This study aimed to understand the experiences and feelings of patients undergoing lower limb vein harvesting for coronary artery bypass grafting (CABG).

Key Points

To investigate the lived experiences, perceptions, and psychological responses of patients undergoing lower limb saphenous vein harvesting for coronary artery bypass grafting.
Conducted a single-centre qualitative phenomenological study utilizing purposive sampling at a Grade A hospital in Nanjing, China.
Enrolled 23 patients (16 men, 7 women; 6 aged 40–50, 9 aged 51–60, and 8 aged >60 years) who underwent coronary artery bypass grafting with saphenous vein harvesting between October 2024 and March 2025.
Conducted semistructured interviews and analyzed transcripts using Colaizzi's seven-step method in NVivo 12 Plus software.
Identified four core themes: preoperative cognitive differences influencing decision-making, postoperative physiological changes triggering psychological distress, diverse coping strategies and support needs, and reconstruction of body image and identity.
Found that patients prioritized cardiac threats preoperatively while neglecting leg harvest risks, which led to postoperative shock, fear of movement due to intense pain, and frustration over impaired lower limb mobility.
Revealed that discrepancy between preoperative expectations and postoperative reality often induced anger and regret, prompting self-tolerance and a need for multidimensional support.

Structured PICO

P

Population

23 patients who underwent coronary artery bypass grafting with saphenous vein harvesting at a single center in China, interviewed to explore their experiences with the lower limb harvest site.

E

Exposure

Lower limb vein harvesting for coronary artery bypass grafting (qualitative experience)

O

Outcome

Patients' experiences and feelings regarding lower limb vein harvestingpatient reported

Limitations

Conducted at only one institution.
Focused solely on patients' perspectives.
Potential social desirability bias as the interviewer was a cardiac surgery nurse at the center.
Conducted at only one institution
Focused solely on patients' perspectives

Implication

Patients undergoing CABG with lower limb vein harvesting experience significant psychological and physical distress related to the harvest site, highlighting the need for improved perioperative education and support.

Abstract

OBJECTIVE: This study aimed to understand the experiences and feelings of patients undergoing lower limb vein harvesting for coronary artery bypass grafting (CABG). DESIGN: Qualitative, phenomenological research methodology with purposive sampling. Semistructured interview data were analysed using Colaizzi's seven-step method with the NVivo 12 Plus software. SETTING: A single-centre study in a Grade A hospital in Nanjing, China. PARTICIPANTS: A total of 23 patients who underwent CABG with saphenous vein harvesting between October 2024 and March 2025. RESULTS: The participants' experiences were summarised into four themes: preoperative cognitive differences influencing decision-making, postoperative physiological changes triggering psychological distress, diverse coping strategies and support needs, and reconstruction of body image and identity. CONCLUSION: Medical staff should pay attention to the feelings of patients undergoing CABG with vein harvesting from the lower limbs. By actively implementing shared decision-making, promoting high-quality nursing services, improving multidimensional support systems, and enhancing patients' psychological and social adaptability, healthcare professionals can improve patients' perioperative experiences and promote their comprehensive recovery.

Discussion

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Cite This Study

Liu et al. (2026) studied Coronary artery bypass grafting (CABG) with saphenous vein harvesting (n=23). Lower limb vein harvesting for CABG was evaluated on Patients' experiences and feelings regarding lower limb vein harvesting. Patients undergoing CABG with lower limb vein harvesting experience preoperative cognitive differences, postoperative psychological distress from physiological changes, and a need for body image reconstruction.

synapsesocial.com/papers/6a5b38f68167787360d24de5 https://doi.org/10.1136/bmjopen-2025-110448

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The neglected second wound: a qualitative study of patients’ experiences of lower limb vascular harvesting for coronary artery bypass grafting

Key Points

Structured PICO

Limitations

Implication

Abstract

Discussion

Cite This Study

The neglected second wound: a qualitative study of patients’ experiences of lower limb vascular harvesting for coronary artery bypass grafting

Key Points

Structured PICO

Limitations

Implication

Abstract

Discussion

Cite This Study

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