Predictors for outcome after vacuum assisted closure therapy of peri-vascular surgical site infections in the groin

Eur J Vasc Endovasc Surg. 2008 Jul;36(1):84-9. doi: 10.1016/j.ejvs.2007.12.020. Epub 2008 Mar 4.

Abstract

Objectives: 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.

Design: Retrospective study.

Materials: 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.

MeSH terms

  • Aged
  • Aged, 80 and over
  • Amputation, Surgical
  • Blood Vessel Prosthesis / adverse effects*
  • Blood Vessel Prosthesis Implantation / instrumentation*
  • Female
  • Femoral Artery / surgery*
  • Groin / blood supply*
  • Hemorrhage / etiology
  • Hospital Costs
  • Humans
  • Male
  • Middle Aged
  • Negative-Pressure Wound Therapy* / adverse effects
  • Negative-Pressure Wound Therapy* / economics
  • Prosthesis-Related Infections / etiology
  • Prosthesis-Related Infections / microbiology
  • Prosthesis-Related Infections / mortality
  • Prosthesis-Related Infections / surgery*
  • Registries
  • Retrospective Studies
  • Surgical Wound Infection / etiology
  • Surgical Wound Infection / microbiology
  • Surgical Wound Infection / mortality
  • Surgical Wound Infection / surgery*
  • Time Factors
  • Treatment Outcome
  • Vascular Surgical Procedures / adverse effects*
  • Vascular Surgical Procedures / instrumentation
  • Wound Healing