SARTORIUS MYOPLASTY FOR INFECTED VASCULAR GRAFTS IN THE GROIN - SAFE,DURABLE, AND EFFECTIVE

Objective: To review the safety, durability, and efficacy of sartorius myoplasty in the treatment of localized vascular prosthetic graft inf ection in the groin. Design: Case series. Setting: University teaching hospitals. Patients: Fourteen patients with 15 exposed, eroded, or ov ertly infected prosthetic vascular grafts in the groin, treated during 7 years. Interventions: Groin exploration for delineation of the exte nt of vascular graft infection, followed by extensive perigraft debrid ement, then dissection and rotation of the ipsilateral sartorius muscl e to cover the involved graft. Main Outcome Measures: Healing of groin wound with preservation of vascular graft function, limb salvage, len gth 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 functi onal 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 pr ogressive 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.