Sartorius myoplasty for infected vascular grafts in the groin. Safe, durable, and effective
B. Maser, N. Vedder, D. Rodriguez and K. Johansen
Division of Vascular Surgery, University of Washington Affiliated Hospitals, Seattle, USA.
OBJECTIVE: To review the safety, durability, and efficacy of sartorius
myoplasty in the treatment of localized vascular prosthetic graft infection
in the groin. DESIGN: Case series. SETTING: University teaching hospitals.
PATIENTS: Fourteen patients with 15 exposed, eroded, or overtly infected
prosthetic vascular grafts in the groin, treated during 7 years.
INTERVENTIONS: Groin exploration for delineation of the extent of vascular
graft infection, followed by extensive perigraft debridement, then
dissection and rotation of the ipsilateral sartorius muscle to cover the
involved graft. MAIN OUTCOME MEASURES: Healing of groin wound with
preservation of vascular graft function, limb salvage, length of hospital
stay, impact of specific wound bacteria, and evidence of long-term hip
dysfunction. RESULTS: During a mean hospital stay of 8.7 days, sartorius
myoplasty was accomplished with 20% morbidity. Hip flexor function was
initially impaired in all 14 patients, but functional deficit was
negligible at late assessment. During mean follow-up of 36 months, all
wounds were healed, and all limbs were salvaged. Two late deaths occurred,
and 2 limbs were ultimately amputated due to progressive loss of vascular
outflow. CONCLUSION: Sartorius myoplasty is a simple, safe, durable, and
effective technique for preservation of locally infected or exposed
vascular grafts in the groin.
