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Sartorius myoplasty for infected vascular grafts in the groin. Safe, durable, and effective
B Maser1, N Vedder, D Rodriguez
1Division of Vascular Surgery, University of Washington Affiliated Hospitals, Seattle, USA.
Objective:
To review the safety, durability, and efficacy of sartorius myoplasty in the treatment of localized vascular prosthetic graft infection in the groin.
Design:
Case series.
Setting:
University teaching hospitals.
Patients:
Fourteen patients with 15 exposed, eroded, or overtly infected prosthetic vascular grafts in the groin, treated during 7 years.
Interventions:
Groin exploration for delineation of the extent of vascular graft infection, followed by extensive perigraft debridement, then dissection and rotation of the ipsilateral sartorius muscle to cover the involved graft.
Main Outcome Measures:
Healing of groin wound with preservation of vascular graft function, limb salvage, length of hospital stay, impact of specific wound bacteria, and evidence of long-term hip dysfunction.
Results:
During a mean hospital stay of 8.7 days, sartorius myoplasty was accomplished with 20% morbidity. Hip flexor function was initially impaired in all 14 patients, but functional deficit was negligible at late assessment. During mean follow-up of 36 months, all wounds were healed, and all limbs were salvaged. Two late deaths occurred, and 2 limbs were ultimately amputated due to progressive loss of vascular outflow.
Conclusion:
Sartorius myoplasty is a simple, safe, durable, and effective technique for preservation of locally infected or exposed vascular grafts in the groin.
Insights
Sartorius myoplasty effectively treats groin vascular prosthetic graft infections, ensuring wound healing and limb salvage. This safe and durable technique preserves graft function with minimal long-term hip dysfunction.
Area of Science:
- Vascular Surgery
- Surgical Techniques
- Infectious Disease Management
Background:
- Groin vascular prosthetic graft infections pose significant challenges.
- Preserving graft function and limb viability is paramount.
Purpose of the Study:
- To evaluate the safety, durability, and efficacy of sartorius myoplasty for localized groin vascular prosthetic graft infections.
Main Methods:
- A case series involving 14 patients with infected prosthetic vascular grafts in the groin.
- Sartorius myoplasty involved graft debridement and muscle flap coverage.
- Outcomes included wound healing, limb salvage, and hip function.
Main Results:
- Sartorius myoplasty achieved 100% wound healing and limb salvage in the mean 36-month follow-up.
- Initial hip flexor impairment resolved, with negligible long-term deficit.
- Morbidity was 20%, with two late deaths and two amputations due to unrelated vascular issues.
Conclusions:
- Sartorius myoplasty is a simple, safe, and effective method for managing infected groin vascular grafts.
- The technique demonstrates durability in preserving graft function and salvaging limbs.