title: The vacuum-assisted closure (V.A.C®) system for surgical site infection with involved vascular grafts.
abstract: BACKGROUND
  In vascular surgery, surgical site infection is the most common postoperative morbidity, occurring in 5-10% of vascular patients. The optimal management of surgical site infection with involved lower limb vascular grafts remains controversial. We present our 6-year results of using the V.A.C.® system in surgical site infection with involved vascular grafts.
  
  
  METHODS
  A retrospective 6-year review of patient who underwent a VAC® therapy for postoperative surgical site infection in lower limb with involved vascular grafts in our department between January 2006 and December 2011. V.A.C therapy was used in 40 patients. All patients underwent surgical wound revision with VAC® therapy and antibiotics.
  
  
  RESULTS
  The mean time of use of the V.A.C. system was 14.2 days. After mean of 12 days in 34 of 40 patients, in whom the use of VAC® therapy resulted in delayed primary closure or healing by secondary intention. The mean postoperative follow-up time was 61.67 months, during which 3 patients died.
  
  
  CONCLUSIONS
  We showed that the V.A.C.® system is valuable for managing specifically surgical site infection with involved vascular grafts. Using the V.A.C.® system, reoperation rates are reduced; 85% of patients avoided graft replacement.
authors.affiliation: Department of Cardiovascular surgery, University Hospital of Geneva, Geneva, Switzerland saziye.karaca@hcuge.ch.
authors.forename: Karaca
authors.initials: K
authors.lastname: Saziye
authors.affiliation: Department of Cardiovascular surgery, University Hospital of Geneva, Geneva, Switzerland.
authors.forename: Kalangos
authors.initials: K
authors.lastname: Afksendiyos
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D001807:Blood Vessel Prosthesis / Q000009:adverse effects; D005260:Female; D006119:Groin / Q000601:surgery; D006801:Humans; D008297:Male; D008875:Middle Aged; D054843:Negative-Pressure Wound Therapy / Q000295:instrumentation / Q000379:methods; D012086:Reoperation; D012189:Retrospective Studies; D013530:Surgical Wound Infection / Q000628:therapy*; D058017:Vascular Grafting / Q000009:adverse effects*; D014945:Wound Healing / Q000187:drug effects*
keywords: SSI; VAC; vascular graft infection; wound infection