Salvage of Exposed Groin Vascular Grafts with Early Intervention Using Local Muscle Flaps.
BACKGROUND
Peripheral vascular surgery may be complicated by wound infection and potential graft exposure in the groin area. Muscle flap coverage of the graft has been promoted to address these wound complications. The authors present their findings regarding graft salvage rates and patient outcomes using local muscle flaps to address vascular graft complications of the groin.


METHODS
Data were obtained by retrospective cohort study of patients who underwent a local muscle flap procedure by a single surgeon following vascular graft complication in the groin.


RESULTS
Seventeen patients undergoing local muscle flap coverage of a vascular graft were reviewed. Six men and 9 women, 51-80 years old, were included in the study. Wound complications in the groin occurred anywhere from 3 days to 3.5 years following graft placement. Graft exposure was the most common presenting complication (14 of 17 patients). Muscle flap coverage occurred within 15 days of complication presentation in all patients (average, 6.4 days). Seven of the 15 patients experienced postoperative complications within 6 months of the procedure, most commonly wound dehiscence. However, analysis demonstrated that vascular grafts were successfully salvaged in 10 of the 17 patients (59%) over the course of follow-up (range, 104-1748 days). Average time to muscle flap coverage was 4.2 days in patients who retained the graft and 9.6 days in patients who ultimately lost their vascular graft.


CONCLUSIONS
The authors demonstrate improved vascular graft salvage rate when local muscle flap procedure is performed early after initial wound complication presentation.
Division of Plastic, Reconstructive, Maxillofacial and Oral Surgery, Department of Surgery, Duke University Medical Center, Durham, N.C.; and Division of Vascular Surgery, Department of Surgery, Duke University Medical Center, Durham, N.C.
Brian L
BL
May
Division of Plastic, Reconstructive, Maxillofacial and Oral Surgery, Department of Surgery, Duke University Medical Center, Durham, N.C.; and Division of Vascular Surgery, Department of Surgery, Duke University Medical Center, Durham, N.C.
Nicole A
NA
Zelenski
Division of Plastic, Reconstructive, Maxillofacial and Oral Surgery, Department of Surgery, Duke University Medical Center, Durham, N.C.; and Division of Vascular Surgery, Department of Surgery, Duke University Medical Center, Durham, N.C.
Sanjay V
SV
Daluvoy
Division of Plastic, Reconstructive, Maxillofacial and Oral Surgery, Department of Surgery, Duke University Medical Center, Durham, N.C.; and Division of Vascular Surgery, Department of Surgery, Duke University Medical Center, Durham, N.C.
Matthew W
MW
Blanton
Division of Plastic, Reconstructive, Maxillofacial and Oral Surgery, Department of Surgery, Duke University Medical Center, Durham, N.C.; and Division of Vascular Surgery, Department of Surgery, Duke University Medical Center, Durham, N.C.
Cynthia K
CK
Shortell
Division of Plastic, Reconstructive, Maxillofacial and Oral Surgery, Department of Surgery, Duke University Medical Center, Durham, N.C.; and Division of Vascular Surgery, Department of Surgery, Duke University Medical Center, Durham, N.C.
Detlev
D
Erdmann