Sartorius transposition to protect vascular grafts in the groin

Fifty-two patients who required reexploration through the groin incision within seven days of an arterial procedure were studied to assess the value of sartorius transposition. Twenty-four group I patients had the sartorius muscle used to cover the vascular graft at reoperation while 28 group II patients had a standard closure. The groups were similar with respect to age, initial arterial operation, incidence of diabetes, and use of antibiotics and postoperative anticoagulation. Wound complications were frequent in both groups (62.5% vs. 57.1%, respectively) but outcome of these wound problems was quite different. Graft infection and anastomotic disruption were significantly less frequent in group I patients. Because fewer infected prostheses had to be removed group I patients were less likely to require high level amputations. Sartorius transposition is an effective method of protecting vascular grafts jeopardized by the high frequency of wound problems associated with early reoperation.