Srpski arhiv za celokupno lekarstvo 2016 Volume 144, Issue 11-12, Pages: 621-625
https://doi.org/10.2298/SARH1612621M
Full text ( 178 KB)
Cited by
Negative-pressure wound therapy for deep groin vascular infections
Matić Predrag (Dedinje Cardiovascular Institute, Belgrade + School of Medicine, Belgrade)
Tanasković Slobodan (Dedinje Cardiovascular Institute, Belgrade + School of Medicine, Belgrade)
Živić Rastko (School of Medicine, Belgrade + Clinical Center „Dr Dragiša Mišović“, Belgrade)
Jocić Dario (Dedinje Cardiovascular Institute, Belgrade)
Gajin Predrag (Dedinje Cardiovascular Institute, Belgrade + School of Medicine, Belgrade)
Babić Srđan (Dedinje Cardiovascular Institute, Belgrade + School of Medicine, Belgrade)
Soldatović Ivan (School of Medicine, Institute of Medical Statistics and Informatics, Belgrade)
Vučurević Goran (Dedinje Cardiovascular Institute, Belgrade)
Nenezić Dragoslav (Dedinje Cardiovascular Institute, Belgrade + School of Medicine, Belgrade)
Radak Đorđe (Dedinje Cardiovascular Institute, Belgrade + School of Medicine, Belgrade)
Introduction. Infection of synthetic graft in the groin is a rare but
devastating complication. When it occurs, several possibilities of treatment
are available. Extra-anatomic reconstruction and in-situ implantation of new,
infection resistant grafts are associated with high mortality and morbidity.
Therefore, more conservative approach is needed in some cases.
Negative-pressure wound therapy is one of the options in treating such
patients. Objective. The aim of this study was to assess the outcome for deep
groin vascular graft infection treated with negative-pressure wound therapy.
Methods. Seventeen patients (19 wounds), treated for Szilagyi grade III groin
infections between October 2011 and June 2014, were enrolled into this
observational study. Results. Majority of the wounds (11/19) were healed by
secondary intention, and the rest of the wounds (8/19) were healed by primary
intention after initial negative-pressure wound therapy and graft
substitution with silver-coated prostheses or autologous artery/vein
implantation. No early mortality was observed. Minor bleeding was observed in
one patient. Reinfection was noted in three wounds. Only one graft occlusion
was noted. Late mortality was observed in three patients. Conclusion.
Negative-pressure wound therapy seems to be safe for groin vascular graft
infections and comfortable for both patient and surgeon. However, the rate of
persistent infection is high. This technique, in our opinion, can be used as
a “bridge” from initial wound debridement to definitive wound management,
when good local conditions are achieved for graft substitution, either with
new synthetic graft with antimicrobial properties or autologous artery/vein.
In selected cases of deep groin infections it can be used as the only
therapeutic approach in wound treatment.
Keywords: groin infection, synthetic graft infection, negative-pressure wound therapy