Wound infection after reconstructive arterial surgery of the lower limbs: risk factors and consequences

To identify predictors, and clinical consequences, of postoperative wound infection after peripheral vascular surgery.

Retrospective cohort study. Potential predictors of wound infection were sought among patient related factors and procedure related factors. Patient outcome was then analysed according to the incidence of wound infection.

Following 209 procedures, 20 (9.6%) patients suffered a wound infection. On univariate analysis, infrainguinal surgery, use of vein graft, and tissue loss were associated with wound infection. On multivariate regression, however, only the association with use of a vein graft remained (OR = 4.2; 95%CI = 1.2-14.1; P = .022): the incidence of wound infection was 16/96 (17%; 95%CI = 9.2-24.1) when a vein graft was used and 4/113 (3.5%; 95%CI = .1-7%) when a prosthetic or no graft was used. Wound infection was associated with increased mortality (4/20 versus 9/189; P = .025) but not limb loss (2/20 versus 7/189; P = .208). Median (IQR) postoperative hospital stay in patients with wound infection was 22 (15-45) days and 8 (5-15) days in those without wound infection (P = .001).

In lower limb arterial surgery, wound infection is associated with the use of vein grafts, and results in delayed recovery and increased mortality. Measures to reduce wound infection should be focussed on such patients.