Use of Vacuum Assisted Closure in Vascular Graft Infection Confined to the Groin

PURPOSE: In this report we share our experience with the use of the VAC system as a less invasive means of graft preservation and an effective alternative to routine muscle flap closure, in patients with groin wound healing complications following lower limb vascular procedures. We also review the English literature regarding the use of VAC therapy on infected groin wounds when the infection affects the prosthesis. PATIENTS AND METHODS: eight patients treated with delayed healing of a groin incision following a femoral artery surgery. In six cases local exploration or CT examination showed evidence of graft involvement (Szilagyi grade III). RESULTS: Mean duration of VAC use was 21.5 days (range, 10 to 45). The wounds were filled with granulation tissue by day 10 with no purulent-inflammatory exudates. At the end of VAC therapy, final closure was easily achieved by either healing by secondary intention or delayed primary closure. No patient required use of muscle flaps. There were no reinfections at 1 to 28 month follow-up (mean, 17.2 months/ one case lost to follow-up). CONCLUSION: Our initial experience with VAC therapy to treat non healing groin wounds following vascular reconstructions is very promising. Negative pressure therapy resulted in control lymph leakage, achieving healing and managing infection.