Related Experiment Video
Updated: May 2, 2026
Engineered Vascularized Muscle Flap
Published on: January 11, 2016
Prophylactic Sartorius Flap Reconstruction Is Associated With Reduced Vascular Graft Infection
Young Kim1, Roberto S Loanzon1, Christina L Cui1
1Division of Vascular and Endovascular Surgery, Department of Surgery, Duke University, Durham, North Carolina.
Introduction:
Complications in the femoral area following vascular surgery are frequent and linked to considerable morbidity, including the risk of underlying graft infection. Sartorius muscle flaps are an important adjunct for the treatment of wound complications. In this study, we examined our experience with prophylactic sartorius muscle flap coverage and its association with prosthetic vascular graft infection.
Methods:
In this single-center analysis, electronic medical records were retrospectively reviewed for all sartorius muscle flap procedures performed from 2012 to 2021. Prophylactic indication was defined as flap reconstruction during index revascularization in the absence of active inguinal infection.
Results:
Over the 9-y period, a total of 54 prophylactic sartorius flaps were performed in 47 patients. The median patient age was 66 y (interquartile range [IQR] 61-77 y). Wound complications requiring reintervention occurred in 16 (29.6%) patients, including 6 (11.1%) surgical site infections, 5 (9.3%) wound dehiscence, and 5 (9.3%) infected seromata. Among patients suffering wound complications, 30-d readmission (75.0% versus 26.3%, P = 0.004) and reoperative flap creation rates (25.0% versus 2.6%, P = 0.010) were higher, whereas 30-d mortality rates (0.0% versus 5.3%, P = 0.51) were similar. Only one patient (1.9%) developed vascular graft infection over a median follow-up period of 2.4 y (IQR 0.9-4.0 y). On multivariate analysis, body mass index (adjusted odds ratio 1.23, 95% confidence interval, 1.12-1.35, P = 0.023) was associated with reoperative wound complications.
Conclusions:
Wound complications were common after prophylactic sartorius flap creation in this high-risk population; however, infection of the underlying vascular graft was rare. These data suggest that sartorius flap may be effective in a prophylactic role.
Insights
Prophylactic sartorius muscle flaps are effective in preventing vascular graft infections after femoral surgery. While wound complications occurred, graft infection rates were notably low, suggesting a beneficial role for these flaps.
Area of Science:
- Vascular Surgery
- Reconstructive Surgery
- Wound Management
Background:
- Femoral wound complications post-vascular surgery are common and can lead to graft infections.
- Sartorius muscle flaps are utilized to manage wound complications effectively.
Purpose of the Study:
- To evaluate the efficacy of prophylactic sartorius muscle flaps in preventing prosthetic vascular graft infections.
- To analyze the association between prophylactic sartorius flaps and graft infection rates.
Main Methods:
- Retrospective review of electronic medical records for sartorius muscle flap procedures from 2012-2021.
- Defined prophylactic indication as flap reconstruction during index revascularization without active infection.
Main Results:
- 54 prophylactic sartorius flaps were performed in 47 patients over 9 years.
- Wound complications (infection, dehiscence, seroma) occurred in 29.6% of patients.
- Vascular graft infection was rare (1.9%) with a median follow-up of 2.4 years.
Conclusions:
- Wound complications were frequent following prophylactic sartorius flap creation in high-risk patients.
- Prophylactic sartorius flaps appear effective in preventing underlying vascular graft infections.
- Higher body mass index was associated with reoperative wound complications.
