We appreciate the interest shown by Dr Allen in our work concerning leg harvest surgical site infection rates after coronary artery bypass graft surgery and the opportunity to respond to his comments. We agree that many wound complications occur after discharge and, as stated in our article, share his concern that some may be missed if outpatient follow-up is incomplete. We should note, however, that the Society of Thoracic Surgeons (STS) database calls for 30-day follow-up, not just in-hospital follow-up. Indeed, as stated in the Methods section, at Washington University our data coordinators contact all treating physicians and cardiothoracic surgeons by phone at 30 days after the operation for follow-up information. Because the National Nosocomial Infection Surveillance System/Centers for Disease Control (NNIS/CDC) definition of surgical site infection requires that signs and symptoms of infection begin within 30 days of surgery, 1 by definition late-onset infections were not included in our study.Dr Allen also reminds us of significant contributions from other authors. We did indeed cite other publications by these same authors, and we appreciate the addition of the reference by Allen and colleagues 2 to the debate. The publications cited in Allen's letter, however, describe risk factors associated with wound complications in general 2,3 or impaired wound healing 4 after saphenous vein harvest in patients undergoing coronary artery bypass grafting. In the publication of Allen and colleagues 3 wound complications included hematoma, dehiscence, cellulitis, necrosis, or abscess requiring dressing changes, antibiotics, or de ´bridement. In the publication of Utley and associates, 4 impaired wound healing included inflammation, separation, cellulitis, lymphangitis, drainage, necrosis, or abscess requiring dressings, antibiotics, or de ´bridement. In light of the variety of different complications included in these two studies, it is not surprising that their
