Continuous irrigation as a therapeutic option for graft infections of the groin.

Abstract

Wound infections following vascular procedures occur in 1-7 % of patients and can lead to severe problems including amputation and death. There are no established treatment options for this complication. The aim of our study was to introduce continuous irrigation as a new treatment technique. We retrospectively evaluated patients who had undergone bypass surgery involving the groin and had been treated with continuous irrigation because of deep wound infections. The irrigation solution was saline in all cases. The patients were additionally treated with antibiotics. The end point of the study was either complete wound healing or complications such as recurrent infection, amputation, or death. Wound complications occurred in 65 (15.3 %) of 424 operations. Overall, 20 patients (4.7 %) developed a deep wound infection involving prosthetic graft material. They were treated with continuous irrigation. Complete wound healing was achieved in 13 cases (65.0 %). One patient died. No amputations were necessary. Based on our results, constant irrigation may be a therapeutic option in patients with deep wound infections. The main advantages of continuous irrigation over other treatments are ongoing bacterial reduction despite primary wound closure and the ability to measure the remaining colonization by microbiologic examination of the irrigation fluid.