Predictors for outcome after vacuum assisted closure therapy of peri-vascular surgical site infections in the groin

Objectives: To assess outcomes (wound heating, amputation and mortality) after vacuum assisted closure (VAC (R)) therapy of peri-vascutar surgical site infections in the groin after arterial surgery. Design: Retrospective study. Materials: Thirty-three groins received VAC (R) therapy between August 2004 and December 2006 at Vascular Centre, Malmo University Hospital. Methods: Following surgical revision, VACO therapy was applied in the groin at a continuous topical negative pressure of 125 mm Hg. The median follow up time was 16 months. Results: Median age was 75 years. Twenty-three (70%) cases underwent surgery for lower limb ischaemia. Intestinal flora was present in 88% of the wound cultures. Median duration of VACO therapy was 20 days and 27 (82%) wounds heated within 55 days. One serious VAC (R) associated bleeding and three late false femoral artery aneurysms were reported. The median cost of VACO treatment was 2.7% of the in-hospital costs. Synthetic vascular graft infection (n = 21) was associated with adverse infection-retated events (n = 9; p = 0.012). Non-heating wounds were associated with amputation (p = 0.005) and death (p < 0.001). Conclusions: VAC (R) treated synthetic vascular graft infections in the groin were at a greater risk of developing infection-related complications. Non-heating surgical site infections after VAC (R) therapy were associated with amputation and death. (C) 2008 European Society for Vascular Surgery. Published by Elsevier Ltd. All rights reserved.