Predictors for outcome after vacuum assisted closure therapy of peri-vascular surgical site infections in the groin.
OBJECTIVE
To assess outcomes (wound healing, amputation and mortality) after vacuum assisted closure (VAC) therapy of peri-vascular surgical site infections in the groin after arterial surgery.


METHODS
Retrospective study.


METHODS
Thirty-three groins received VAC therapy between August 2004 and December 2006 at Vascular Centre, Malmö University Hospital.


METHODS
Following surgical revision, VAC therapy was applied in the groin at a continuous topical negative pressure of 125 mmHg. The median follow up time was 16 months.


RESULTS
Median age was 75 years. Twenty-three (70%) cases underwent surgery for lower limb ischaemia. Intestinal flora was present in 88% of the wound cultures. Median duration of VAC therapy was 20 days and 27 (82%) wounds healed within 55 days. One serious VAC associated bleeding and three late false femoral artery aneurysms were reported. The median cost of VAC treatment was 2.7% of the in-hospital costs. Synthetic vascular graft infection (n=21) was associated with adverse infection-related events (n=9; p=0.012). Non-healing wounds were associated with amputation (p=0.005) and death (p<0.001).


CONCLUSIONS
VAC treated synthetic vascular graft infections in the groin were at a greater risk of developing infection-related complications. Non-healing surgical site infections after VAC therapy were associated with amputation and death.
Svensson
S
S
Vascular Centre, Malmö University Hospital, Sweden.
Monsen
C
C
Kölbel
T
T
Acosta
S
S
D000368:Aged; D000369:Aged, 80 and over; D000671:Amputation, Surgical; D001807:Blood Vessel Prosthesis / Q000009:adverse effects*; D019917:Blood Vessel Prosthesis Implantation / Q000295:instrumentation*; D005260:Female; D005263:Femoral Artery / Q000601:surgery*; D006119:Groin / Q000098:blood supply*; D006470:Hemorrhage / Q000209:etiology; D017721:Hospital Costs; D006801:Humans; D008297:Male; D008875:Middle Aged; D054843:Negative-Pressure Wound Therapy / Q000009:adverse effects / Q000191:economics; D016459:Prosthesis-Related Infections / Q000209:etiology / Q000382:microbiology / Q000401:mortality / Q000601:surgery*; D012042:Registries; D012189:Retrospective Studies; D013530:Surgical Wound Infection / Q000209:etiology / Q000382:microbiology / Q000401:mortality / Q000601:surgery*; D013997:Time Factors; D016896:Treatment Outcome; D014656:Vascular Surgical Procedures / Q000009:adverse effects* / Q000295:instrumentation; D014945:Wound Healing