title: Use of muscle flap to cover infections of the carotid artery after carotid endarterectomy.
abstract: Wound infection after carotid endarterectomy is an extremely uncommon complication. This complication occurred in two of our patients in a series of 170 consecutive carotid endarterectomies over the last 3 years. There has been an increased use of prosthetic patch grafts to close carotid endarterectomy sites. However, the presence of infection in the setting of prosthetic graft material poses difficulties in management and may lead to life-threatening complications. Recent strategies for the management of wound infections (in cases where the artery/graft interface is intact) include the use of appropriate antibiotics, repeated wound debridement, and covering the tissue defect or the perigraft area with well-vascularized muscle flap. In this case report the use of sternocleidomastoid muscle flap as a coverage for the infected area is described. The use of sternocleidomastoid muscle flap helped control the infective process and secured the viability of the patched carotid arteries.
authors.affiliation: MetroWest Medical Center, Framingham, MA 01701, USA.
authors.forename: D C
authors.initials: DC
authors.lastname: Zacharoulis
authors.forename: S K
authors.initials: SK
authors.lastname: Gupta
authors.forename: P
authors.initials: P
authors.lastname: Seymour
authors.forename: R A
authors.initials: RA
authors.lastname: Landa
mesh_terms: D000900:Anti-Bacterial Agents; D002343:Carotid Artery, Internal / Q000601:surgery*; D016893:Carotid Stenosis / Q000601:surgery; D003646:Debridement; D004359:Drug Therapy, Combination / Q000627:therapeutic use; D016894:Endarterectomy, Carotid / Q000009:adverse effects*; D005260:Female; D006801:Humans; D002546:Ischemic Attack, Transient / Q000601:surgery; D008875:Middle Aged; D009334:Neck Muscles / Q000637:transplantation*; D011138:Polytetrafluoroethylene; D019736:Prostheses and Implants / Q000009:adverse effects; D013203:Staphylococcal Infections / Q000188:drug therapy / Q000601:surgery; D013524:Surgical Flaps / Q000379:methods*; D013530:Surgical Wound Infection / Q000188:drug therapy / Q000601:surgery*; D014022:Tissue Survival
chemical_list: D000900:Anti-Bacterial Agents; D011138:Polytetrafluoroethylene