Outcome and Complications Using Negative Pressure Wound Therapy in the Groin for Perivascular Surgical Site Infections after Vascular Surgery.

BACKGROUND: The aim of this study was to investigate graft preservation, major bleeding, and reinfection rate using negative pressure wound therapy (NPWT) for perivascular surgical site infections (SSIs) in the groin after vascular surgery and factors associated with failure of treatment.

METHODS: Retrospective data were collected during 2004-2015. Failure of wound treatment was defined as a wound not healed within 4 months, visible graft material or native artery after 1 month, bleeding from the wound leading to discontinuation of treatment, or death or amputation due to the groin infection.

RESULTS: The median age of the 161 patients was 71 years; 63% were men. The rate of graft preservation rate was 81%; 64% for synthetic grafts. Major bleeding during NPWT occurred in 7.1% and local reinfection in 6.4%. Synthetic graft infection (odds ratio [OR] = 6.1, 95% confidence interval [CI] = 2.6-14.4) and bleeding/pseudoaneurysm as presenting symptom (OR = 2.9, 95% CI = 1.0-8.2) were independently associated with increased failure rate of treatment.

CONCLUSIONS: NPWT is a good option for perivascular SSI in the groin after vascular surgery. Patients with a synthetic graft infection and/or presenting with pseudoaneurysm or bleeding may be considered for an adjunctive or alternative treatment option.