Research Proposal Form for School of Healthcare Sciences

All applications must be completed in line with the guidance notes attached as Appendix I.
Applications must be submitted no later than the deadlines stipulated. Contact the Research
Administrator for dates.
Late applications will not be considered.
School of Healthcare Sciences
Research Proposal Form
2016/17
1, Personal Details
Name of applicant:
Please tick where appropriate;
Student: ☐ Full time: ☐ Part Time: ☐
Title of Course:
Student Number:
Contact Address:
Email address:
Contact telephone number:
Staff: Department:
Email address:
Proposed start date of Study (m/y):
Proposed end date of study (m/y):
Title of Project:

2, Additional Information
Where the project is part of an undergraduate or postgraduate course
Full name of academic supervisor:
Address:
Where the research is being carried out by a member of staff please provide details of co-
investigators
Full Name/s:
Department/School/Institution:
3, Project Details
3.1 Lay Summary
People with coronary artery disease are treated with one procedure known as “coronary artery
bypass graft surgery” or CABG. This disease is characterised by narrowing of coronary arteries. It
is caused by building up of the plaques in the arterial walls, which narrows the inside of the
arteries. In this process the oxygen rich blood reaching the heart muscle is reduced. Therefore, the
blocked portion is bypassed by treating the narrowed artery with another piece of blood vessels or
grafts. One of the methods is harvesting a vein from calf areas of legs or inner thighs usually called
the long saphenous vein. It is also called as autologous venous harvesting (Williams et al. 2012).
There are different forms of harvesting procedures such as open of the vein for grafting, and
endoscopic vein harvesting. The former is known as the traditional approach. There is a debate on
efficacy of the both methods. As per the literature, there are fewer complications with the
endoscopic method when compared to the traditional approach. The traditional approach is
considered to be associated with complications, increased hospital stay, leg pain, and other.
However, the endoscopic method too has its disadvantages. At the time of harvest, there is a risk
of injury. There is also probability of deteriorating effect on the vein graft patency (Barnard and
Keenan 2010).
In order to decide which type of procedure is most effective and beneficial in treating the coronary
artery disease, a critical analysis of the literature will be conducted. Collecting the best evidence
will guide the future effective practice. The data collected from the literature review will help health
care professionals in clinical judgement and decision-making related to surgeries (Silvestri et al.
2013).
3.2 Background and Objectives of Study
Autologous vein harvesting using the extra luminal vein dissector to obtain the sephaneous vein
was found to be beneficial in coronary artery disease patients. The symptomatic benefits include
early mobility and low superficial inflammation. There was no excessive trauma to the vein or any
sign of distraction injury found in the patients. This technique was found to be more effective than
the more traditional dissection technique. There are few studies on this method highlighting
drawbacks (Harskamp et al., 2013). Similarly, using the standard bridging technique for
autologous vein harvesting when compared to the traditional open harvesting technique was found
to be effective in reducing the postoperative leg morbidity. The bridging method was effective in
increasing the patient satisfaction as it was found financially viable (Khan et al., 2010). However,
there is still limited evidence related to functional quality of the vein using the method.
According to Ouzounian et al. (2010) endoscopic saphenous vein harvest is effective in decreasing
the leg wound infections after surgery. It has also been found to improve cosmesis after CABG.
On the other hand it has also been found to reduce the graft patency rates. Other studies
contradict that endoscopic method is not the sole factor for the mid-term adverse outcomes of in-
hospital outcomes. However, drawback of harvesting saphenous vein method includes it limited
visibility using endoscope. Even with illumination, the light is only emitted at the distal portion of the
endoscope. There is need to periodically cleaning the endoscope lens as it gets frequently soiled
on touching the tissue. It is instead considered safer than the open vein harvesting or the excision
method.
An extended literature review will be conducted to identify the effective methods of autologous
venous harvesting in CABG out of traditional approach and the endoscopic method in reducing the
complications after the surgery.

3.3 Principal Research Question
In patients with coronary heart disease, is endoscopic autologous vein
harvesting process more effective than the traditional or open vein harvesting
method in terms of reducing complications?
3.4 Methodology
Literature review will be conducted for accomplishing research objectives. It is the collection of
secondary data through series of steps containing extraction of articles, scrutiny, and elimination of
the irrelevant articles and analysis of selected articles. The analysis will be based on the review of
the abstract, full text, references, and focus on the research question. The results will be critically
appraised and the findings are added up. This process is guided by the PRISMA guidelines
(Fleming et al. 2014).
The databases to be used from the Cardiff University Library include Google Scholar, Cochrane,
Medline, Scopus, and PubMed. The key terms to be used for the search are-
“Coronary artery bypasses surgery”, “CABG graft”, “autologous venous harvesting”, “traditional
method”, “endoscopic venous harvesting”, “Saphenous vein harvest, impact of open versus
endoscopic method in CABG” and other search terms will be used in various combinations.
For effective search various Boolean operators were used such as OR, AND, and both. These
keywords were chosen as mostly used in the abstract and the tile of the journal articles. The
inclusion criteria for the search were research paper published in English Language, between 2000-
2018 and in UK. Research paper not meeting the inclusion criteria is excluded. The rationale for
collecting both old and recent data is the significant amount of research being conducted in that
period. It may be important even in today’s practice (Munn et al. 2014).
3.5 Location of study and access arrangements
The research will be conducted in Cardiff University. It has large library with access to variety of
databases. Students can access the library anytime of the day and use it to fullest via online portal
system. I can access these databases even from my house and anywhere that has the internet
facilities such as cyber cafe.
Has informal consent been obtained to access these facilities/participants?
Yes ☐ No ☐ (Please tick where appropriate)
3.6 Resource Implications
(Staff should also stipulate the source of funding for the research)
All the literature articles will be accessed from the university library. Other resources include
computers, laptops, printers, WiFi or internet, notepad, and other stationery. Assistance is taken
from seniors, mentors and supervisors to ensure the quality and relevance of the literature review.