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

OBJECTIVES: To assess outcomes (wound healing, amputation and mortality) after vacuum assisted closure (VAC((R))) therapy of peri-vascular 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, Malmö University Hospital. METHODS: Following surgical revision, VAC((R)) therapy was applied in the groin at a continuous topical negative pressure of 125mmHg. 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 VAC((R)) therapy was 20 days and 27 (82%) wounds healed within 55 days. One serious VAC((R)) associated bleeding and three late false femoral artery aneurysms were reported. The median cost of VAC((R)) 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). CONCLUSIONS: VAC((R)) 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((R)) therapy were associated with amputation and death.