title: Utility of electrofusion for the femoral approach in vascular surgery: a randomized prospective study.
abstract: BACKGROUND
  The local complications are frequent after a femoral approach in vascular surgery and are often the cause of a delay in healing. Electrofusion showed its effectiveness to decrease the complications in general surgery but was not tested in vascular surgery. The aim of our study was to evaluate if the use of electrofusion in the approach to femoral vessels improved healing at 1 month by decreasing the local complications.
  
  
  METHODS
  This prospective randomized study was conducted in 2 centers from May 1, 2012 to April 30, 2013. All the patients requiring a surgical access of the femoral trigone were included in 2 French teaching hospitals. Femoral artery surgical exposure was carried out using electrofusion or according to the conventional technique (diathermy or cold scalpel) according to a protocol of randomization. The principle criterion of the study was a complete healing at 1 month. The secondary criteria were the appearance of cutaneous, infectious, or lymphatic local complications.
  
  
  RESULTS
  Two hundred ninety-two femoral approaches were carried out in 221 consecutive patients. One hundred forty-eight approaches were carried out with electrofusion and 144 according to the conventional technique. The demographic and operative characteristics were similar between the 2 groups. At 1 month, 86.3% of the approaches were healed without statistically significant difference between the 2 groups (88.5% vs. 84%, P = 0.241). There were less local complications (P = 0.012) and seromas (P = 0.012) in the electrofusion group. This difference could be linked with the least quantities (P = 0.036) and durations (P = 0.014) of drainage observed after approaches carried out with electrofusion. On the other hand, the incidence of cutaneous or infectious complications was not different between the 2 groups.
  
  
  CONCLUSIONS
  In our series, the use of electrofusion decreased the lymphatic complications after a femoral approach. However, the correction of this single parameter was not sufficient to improve the rate of healing at 1 month.
authors.affiliation: Service de Chirurgie Vasculaire, Hôpital Trousseau, Tours, France. Electronic address: flora.gouaillier@free.fr.
authors.forename: Flora
authors.initials: F
authors.lastname: Gouaillier-Vulcain
authors.affiliation: Service de Chirurgie Vasculaire, Hôpital Trousseau, Tours, France.
authors.forename: Etienne
authors.initials: E
authors.lastname: Marchand
authors.affiliation: Service de Chirurgie Vasculaire, Hôpital Trousseau, Tours, France.
authors.forename: Robert
authors.initials: R
authors.lastname: Martinez
authors.affiliation: Service de Chirurgie Vasculaire, Hôpital Larrey, Angers, France.
authors.forename: Jean
authors.initials: J
authors.lastname: Picquet
authors.affiliation: Service de Chirurgie Vasculaire, Hôpital Larrey, Angers, France.
authors.forename: Bernard
authors.initials: B
authors.lastname: Enon
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D004564:Electrocoagulation / Q000009:adverse effects / Q000379:methods*; D005260:Female; D005263:Femoral Artery / Q000601:surgery*; D005602:France; D006784:Hospitals, Teaching; D006801:Humans; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000209:etiology / Q000517:prevention & control; D011446:Prospective Studies; D012307:Risk Factors; D013997:Time Factors; D016896:Treatment Outcome; D014656:Vascular Surgical Procedures / Q000009:adverse effects / Q000379:methods*; D014945:Wound Healing