The sartorius muscle flap: an important adjunct for complicated femoral wounds involving vascular grafts

Am J Surg. 2009 May;197(5):655-9; discussion 659. doi: 10.1016/j.amjsurg.2008.12.020. Epub 2009 Mar 24.

Abstract

Introduction: Femoral wound complications can threaten vascular grafts. Muscle flaps can be used to facilitate soft-tissue coverage and graft salvage. We report a series of sartorius flaps performed by vascular surgeons in the treatment of complicated femoral wounds.

Methods: Rotational sartorius flaps were performed to attempt salvage of underlying vascular grafts. We reviewed a prospective database to determine the outcomes of sartorius flaps on facilitating wound healing and graft salvage and patency.

Results: From 2005 to 2008, 21 sartorius flaps were performed in infected or threatened femoral wounds. Original operations included femoral endarterectomy with patch repair in 8, aortofemoral graft in 6, axillofemoral graft in 4, and femoral-distal bypass in 3 patients. Complete wound healing occurred in 18 patients (86%). Primary wound closure was achieved in 7 patients. Secondary wound closure was achieved in 11 patients with mean healing time of 2.3 months. All vascular reconstructions remained patent at the 9.5-month follow-up.

Conclusions: Sartorius muscle flaps are effective at facilitating complicated femoral wound healing while maintaining graft salvage and patency.

MeSH terms

  • Aged
  • Aneurysm, False / surgery
  • Blood Vessel Prosthesis Implantation*
  • Endarterectomy*
  • Female
  • Femoral Artery / surgery*
  • Graft Survival
  • Hematoma / surgery
  • Humans
  • Male
  • Middle Aged
  • Postoperative Complications / surgery*
  • Retrospective Studies
  • Surgical Flaps*
  • Surgical Wound Dehiscence / surgery
  • Surgical Wound Infection / surgery
  • Vascular Patency
  • Wound Healing