Role of Prophylactic Sartorius Flaps for Preventing Deep Space Infection in Lower Extremity Revascularization

Area of Science:

• Vascular Surgery
• Surgical Site Infections
• Limb Preservation

Background:

• Groin infections are a significant complication in vascular surgery, impacting limb salvage.
• Preventing deep space infection (DSI) is crucial for successful surgical outcomes.
• Limited literature exists on the efficacy of prophylactic flaps in preventing DSI.

Purpose of the Study:

• To compare the effectiveness of prophylactic sartorius flaps versus layered closure in preventing 30-day hospital readmission for DSI.
• To evaluate the impact of incision orientation (oblique vs. vertical) on DSI rates.
• To assess the role of patient factors such as previous groin surgery and obesity.

Main Methods:

• Retrospective study of vascular surgery patients undergoing femoral artery exposure (2017-2021).
• Comparison of prophylactic sartorius flaps versus layered closure for DSI readmission.
• Analysis of incision orientation (oblique vs. vertical) as a secondary outcome.
• Exclusion of patients with active groin infections.

Main Results:

• Sartorius flaps showed a trend towards lower DSI rates (1.9% vs. 6.6%) compared to layered closure, though not statistically significant due to sample size.
• No significant difference in DSI rates was observed between oblique and vertical incisions (4.3% vs. 5.7%).
• Sartorius flaps were associated with a higher rate of prior groin surgery, indicating their use in more complex cases.

Conclusions:

• Prophylactic sartorius flaps may offer a protective benefit against deep space infections in vascular surgery groin procedures.
• Further research with a larger sample size is warranted to confirm the statistical significance of sartorius flaps in DSI prevention.
• Sartorius flaps represent a potentially simple and effective strategy for mitigating groin complications in vascular surgery.