Inguinal wound fluid collections after vascular surgery: management by early reoperation

Inguinal wounds complicated by significant fluid collections after vascular grafting procedures were managed by exploration soon after recognition in 14 patients. Within 24 hours, incisions were reexplored, fluid collections were evacuated and cultured, and closed suction drains were placed. The wound was reapproximated, and broad spectrum antibiotics were given intravenously until 24 hours after removal of the drain. Variables evaluated included spontaneous drainage before exploration, positive intraoperative wound cultures, exposure of graft when the wound was opened, and type of graft used. On careful follow-up, from 5 months to 3.5 years, averaging 14 months, only one patient had an infected graft, occurring 6 months after the wound exploration. There were no complications in wound healing from the inguinal explorations. These results suggest that early exploration and reclosure of clinically significant postoperative fluid collections is safe, results in primary healing, and has a low rate of subsequent graft infection.