title: Better Clinical Practice Could Overcome Patient-Related Risk Factors of Vascular Surgical Site Infections.
abstract: OBJECTIVE
  To clarify the current status of surgical site infection (SSI) during endovascular aortic repair and to define risk factors for SSI among the patients who underwent thoracic or abdominal stent-graft repair through a groin incision.
  
  
  METHODS
  Between 2006 and 2013, data were collected from 1604 patients (mean age 75.2±9.5 years; 1282 men) with 2799 groin incisions for transfemoral access during aortic stent-graft procedures. SSIs were classified as superficial or deep (both occurring within 30 days) or organ/space infections (occurring within 1 year after surgery) according to the Centers for Disease Control and Prevention guidelines. Strategies in place for minimizing SSIs were (1) employing oblique groin incisions, (2) covering the incision with saline-soaked gauze, (3) irrigating the incision thoroughly with saline per layer, and (4) using absorbable sutures.
  
  
  RESULTS
  Overall incidence of SSI was 0.4% (6 patients). The majority of SSIs were late-onset prosthetic graft infections (5, 0.3%). Five of the 6 were successfully treated with conservative therapy; one patient died of sepsis. Univariate analysis showed additional therapy (eg, coil embolization) with a stent-graft procedure was a risk factor for SSI.
  
  
  CONCLUSIONS
  Appropriate antibiotic administration, oblique groin incision, meticulous operative technique, protection against airborne infection during the operation, and closed dressings may avert vascular wound SSIs.
authors.affiliation: Division of Vascular Surgery, Department of Surgery, Jikei University School of Medicine, Tokyo, Japan koji-m@jikei.ac.jp.
authors.forename: Koji
authors.initials: K
authors.lastname: Maeda
authors.affiliation: Division of Vascular Surgery, Department of Surgery, Jikei University School of Medicine, Tokyo, Japan.
authors.forename: Yuji
authors.initials: Y
authors.lastname: Kanaoka
authors.affiliation: Division of Vascular Surgery, Department of Surgery, Jikei University School of Medicine, Tokyo, Japan.
authors.forename: Takao
authors.initials: T
authors.lastname: Ohki
authors.affiliation: Division of Vascular Surgery, Department of Surgery, Jikei University School of Medicine, Tokyo, Japan.
authors.forename: Makoto
authors.initials: M
authors.lastname: Sumi
authors.affiliation: Division of Vascular Surgery, Department of Surgery, Jikei University School of Medicine, Tokyo, Japan.
authors.forename: Naoki
authors.initials: N
authors.lastname: Toya
authors.affiliation: Division of Vascular Surgery, Department of Surgery, Jikei University School of Medicine, Tokyo, Japan.
authors.forename: Tetsuji
authors.initials: T
authors.lastname: Fujita
mesh_terms: D000368:Aged; D001014:Aortic Aneurysm / Q000601:surgery*; D001807:Blood Vessel Prosthesis; D057510:Endovascular Procedures; D005260:Female; D006119:Groin / Q000601:surgery; D006801:Humans; D008297:Male; D012307:Risk Factors; D015607:Stents; D013530:Surgical Wound Infection / Q000517:prevention & control*; D016896:Treatment Outcome; D014656:Vascular Surgical Procedures
keywords: abdominal aortic aneurysm; endograft; endovascular aneurysm repair; infection; stent-graft; thoracic aortic aneurysm; thoracic endovascular aortic repair