Tim Matatov, Kaavya Reddy, Linda M. Doucet, Wayne W. Zhang
Division of Vascular and Endovascular Surgery, Louisiana State University Health Sciences Center-Shreveport, Shreveport, LA.
OBJECTIVES: Groin wound infection is an important cause of postoperative morbidity in vascular surgery patients, especially when prosthetic graft is involved. We report our experience with a new negative pressure incision management system in prevention of groin wound infection following open vascular procedures.
METHODS: The Prevena™ negative pressure incision management system (Kinetic Concepts, Inc. San Antonio, TX) was used on 53 groin incisions in 41 consecutive patients from December 2010 to December 2011. Twenty-seven were males and 14 were females with mean age 52 (range, 23-76) years. The procedures included lower extremity arterial bypass, femoral artery endarterectomy with patch angioplasty, femoral artery exposure for aortic stent grafts, and open repair of vascular injury. The Prevena™ dressing was placed at the end of procedure using sterile technique, and kept in place for 5-7 days. Patients were sent home with Prevena™ system when discharge criteria were met. Incisions were evaluated immediately after removal of the Prevena™ dressing and at one month follow-up.
RESULTS: Of the 53 groin incisions, 2 were excluded from this study because the Prevena™ was removed on postoperative day 2 due to air-leaking around the dressings. Thirty-nine of the rest 51 incisions were vertical (76.4%), and 12 were transverse (23.5%). Prosthetic grafts or patches were used in 32 incisions (62.7%). Three incisions developed Szulgai Grade I cellulitis (5.7%), which healed with 7-day course of oral antibiotics. There was no Szulgai Grade II or III infection (0%) in all 51 incisions.
CONCLUSIONS: The Prevena™ negative pressure incision management system may significantly decrease the rate of Szulgai Grade II and III groin wound complications and subsequently prevent graft infection following vascular surgery. It is safe, portable, and easy to apply. Patient may ambulate with the negative pressure dressing in place. Follow-up to assess possible late prosthetic graft infection is in progress.
AUTHOR DISCLOSURES: L. M. Doucet, Nothing to disclose; T. Matatov, Nothing to disclose; K. Reddy, Nothing to disclose; W. W. Zhang, Nothing to disclose.
Posted April 2012