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Muscle-flap coverage for infected peripheral vascular prostheses

N B Meland1, P G Arnold, P C Pairolero

  • 1Section of Plastic and Reconstructive Surgery, Mayo Clinic, Rochester, Minn.

Plastic and Reconstructive Surgery
|April 1, 1994
PubMed
Summary

Muscle flaps can salvage limbs and lives by covering infected peripheral vascular prostheses. This technique offers a last-ditch effort for patients with severe graft infections, improving outcomes in critical cases.

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Area of Science:

  • Vascular Surgery
  • Infectious Disease
  • Reconstructive Surgery

Background:

  • Peripheral vascular prosthesis infection is a severe complication of arterial reconstructive surgery.
  • Limb loss and mortality rates for graft infections are high (25-75%).
  • Muscle flaps are known for improving wound healing and reducing bacterial counts.

Purpose of the Study:

  • To evaluate the efficacy of using muscle flaps for coverage of infected peripheral vascular prostheses.
  • To assess outcomes in a select group of "end of the line" patients with severe graft infections.

Main Methods:

  • Analysis of 24 infected vascular grafts in 20 patients (ages 52-87).
  • All patients had Grade 3, Stage I-III peripheral graft infections.
  • Muscle flaps (rectus femoris, sartorius, rectus abdominis, pectoralis major) were used for graft coverage.

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Main Results:

  • Aortofemoral reconstruction was the most common initial procedure.
  • Staphylococcus aureus was the most frequent infecting organism.
  • Dacron and polytetrafluoroethylene were the primary graft materials used.

Conclusions:

  • Muscle flaps represent a viable, last-ditch option for salvaging limbs or life in patients with infected peripheral vascular prostheses.
  • This approach is particularly beneficial for select patients with severe, advanced graft infections.