Sources of Staphylococcus epidermidis at the inguinal incision during peripheral revascularization

Staphylococcus epidermidis has been implicated as a major etiologic agent of delayed synthetic vascular graft infection and/or pseudoaneurysm formation at the femoral anastomosis. The source of possible operative graft contamination is debated. Forty-five inguinal incisions in consecutive patients undergoing elective peripheral revascularization were studied. No opening cultures were positive: 30 per cent showed positive nodal cultures; 25 per cent showed positive arterial wall cultures; and 20 per cent showed positive closing cultures, 95 per cent of which were S. epidermidis. There was no correlation with preoperative transfemoral angiography. This high incidence in the tissues of the inguinal incision may be related to the delayed development of S. epidermidis graft infections.