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Published on: January 11, 2016
Sartorius myoplasty for the treatment of infected groins with vascular grafts
J L Perez-Burkhardt1, J A Gonzalez-Fajardo, L A Carpintero
1Division of Vascular Surgery, Hospital Universitario, Valladolid, Spain.
Introduction:
Vascular graft infection is a rare (0.8-2.6%) but serious complication of reconstructive vascular surgery, that comprises limb-threatening when located in the groin.
Purpose:
Review our experience in the treatment of infected groin wounds after femoral surgery by using sartorius myoplasty.
Materials And Methods:
Between January 1989 and October 1993, 13 patients with infected groin wounds involving vascular graft (Grade III of Szilagyi) were treated with local gently debridement, 10% povidone iodide lavage for 5 days, local and systemic antibodies for 14 days and in situ change of the infected graft followed by sartorius myoplasty, detaching its origin from superior anterior iliac spine and fixing it to inguinal ligament, except in one case where tissue cultures were negative and the graft was not changed. Follow-up was done using clinical and echographical criteria at 3, 6, 12 months after operation, and annually.
Results:
Hospital mean stage was 10 days (8-13). The mean follow-up was 36 months (12-65). There was only one immediate complication from hemorrhage that needed surgery. The patient whose graft was not changed developed an abscess in the prosthetic bed 12 weeks after treatment. It was necessary to change it after debridement and antibiotics. No mortality was related to this technique.
Conclusions:
Sartorius myoplasty, with detaching and origin transposition, after in situ change of infected graft, is an excellent therapeutic option for reconstruction and treatment for infected groins with vascular grafts because it is easy to perform and offers very good results in long-term follow-up.
Insights
Sartorius myoplasty effectively treats infected groin wounds after vascular graft surgery. This technique, involving graft replacement and muscle flap reconstruction, shows excellent long-term results with minimal complications.
Area of Science:
- Vascular Surgery
- Infectious Disease Management
- Reconstructive Surgery
Background:
- Vascular graft infection is a rare but severe complication, particularly limb-threatening when in the groin.
- Prompt and effective treatment is crucial for managing these challenging cases.
Purpose of the Study:
- To review the experience with sartorius myoplasty for treating infected groin wounds following femoral vascular surgery.
- To evaluate the efficacy and outcomes of this reconstructive technique.
Main Methods:
- Retrospective review of 13 patients with Grade III Szilagyi infected groin wounds involving vascular grafts.
- Treatment included debridement, povidone-iodine lavage, antibiotics, in situ graft change, and sartorius myoplasty.
- Sartorius myoplasty involved detaching and transposing the muscle origin to the inguinal ligament.
Main Results:
- Mean hospital stay was 10 days, with a mean follow-up of 36 months.
- One patient required reoperation for hemorrhage; another developed an abscess when the graft was not changed.
- No mortality was associated with the sartorius myoplasty procedure.
Conclusions:
- Sartorius myoplasty, combined with in situ graft replacement, is a highly effective treatment for infected groin vascular grafts.
- The procedure is technically straightforward and yields excellent long-term outcomes, preserving limb viability.
