Groin infections following vascular surgery: obturator bypass (BYP) versus "biologic coverage" (TRP)--a comparative...

Deep infections in the groin complicating vascular surgical procedures pose a serious problem, in the treatment of which two alternative methods are available: (1) Removal of the graft and the construction of an extra anatomic bypass (obturator canal bypass, BYP), or (2) retaining the graft and achieving healing of the infected wound by various biological materials, such as omentum or an inferior rectus abdominis muscle flap (TRP). The probability of patient and limb survival was estimated by the Kaplan-Meier method and possible differences between both groups checked using Breslow's and Mantel's tests. No statistically significant differences were found and a variety of factors with potential influence on the outcome were considered equally balanced. However, as soon as the catastrophic event of infection plus haemorrhage enforced emergency surgery, the incidence of success differed markedly: in the BYP group 6 infections healed out of 8 and in the TRP group 1 out of 6.