Predictors for Outcome after Vacuum Assisted Closure Therapy of Peri-vascular Surgical Site Infections in the Groin

ObjectivesTo assess outcomes (wound healing, amputation and mortality) after vacuum assisted closure (VAC®) therapy of peri-vascular surgical site infections in the groin after arterial surgery.DesignRetrospective study.MaterialsThirty-three groins received VAC® therapy between August 2004 and December 2006 at Vascular Centre, Malmö University Hospital.MethodsFollowing surgical revision, VAC® therapy was applied in the groin at a continuous topical negative pressure of 125 mm Hg. The median follow up time was 16 months.ResultsMedian 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 VAC® therapy was 20 days and 27 (82%) wounds healed within 55 days. One serious VAC® associated bleeding and three late false femoral artery aneurysms were reported. The median cost of VAC® treatment was 2.7% of the in-hospital costs. Synthetic vascular graft infection (n = 21) was associated with adverse infection-related events (n = 9; p = 0.012). Non-healing wounds were associated with amputation (p = 0.005) and death (p < 0.001).ConclusionsVAC® treated synthetic vascular graft infections in the groin were at a greater risk of developing infection-related complications. Non-healing surgical site infections after VAC® therapy were associated with amputation and death.