Prophylactic Transversely Hemisected Sartorius Flap for High-Risk Groin Dissections in Vascular Surgery-A Case Series

Area of Science:

• Vascular Surgery
• Surgical Innovation
• Wound Complication Management

Background:

• Groin wound dehiscence and infection are common after femoral artery exposure, potentially leading to graft complications.
• Prosthetic conduits in the groin increase the risk of graft infection and anastomotic breakdown.
• Standard sartorius flaps can be technically challenging and increase operative time.

Purpose of the Study:

• To evaluate the efficacy of a modified Transversely Hemisected Sartorius (THT) flap.
• To assess the THT flap's ability to prevent deep space wound infections and graft loss.
• To determine if the THT flap is a useful adjunct for high-risk patients undergoing femoral artery procedures.

Main Methods:

• A retrospective case series of fifteen patients who received a THT flap after femoral artery exposure.
• Calculation of the Penn Groin Assessment Scale (PGAS) for each patient.
• Primary outcome measured was the rate of deep space wound infections.

Main Results:

• No deep space infections or prosthetic graft excisions occurred in the fifteen patients.
• Six (37.5%) patients developed superficial surgical site infections.
• The THT flap provided effective coverage for prosthetic conduits in eight patients.

Conclusions:

• The modified THT flap is effective in preventing deep space infections and graft loss in high-risk patients.
• This technique maintains segmental blood supply while ensuring adequate coverage of femoral vessels.
• The THT flap offers a less invasive alternative to standard sartorius flaps for groin complication prevention.