["Retro-sartorius bypass" an alternative method during graft infection due to gunshot wound: a case report]

Graft infections can be seen after the peripheric vascular operations using synthetic graft. The patient who had femoro-femoral bypass with synthetic graft after a gunshot wound admitted to our department with graft infection and wide tissue loss. The distal pedal pulses were palpable. At the fifth day, the patient had a bleeding on the graft site and underwent emergency operation. Firstly the infected graft material was excised. Then the proximal end of the PTFE graft anastomosed to the external iliac artery with the lomber incision. A tunnel was formed just medial to the superior crista iliaca and under the inguinal ligament. The PTFE graft was passed through this tunnel excluding the infected area behind sartorius muscle and anastomosed to superficial femoral artery. Control angiography revealed that anastomoses were patent. At the graft infections which are especially with wide tissue loss, the retro-sartorius bypass surgery can be performed successfully as an alternative procedure.