Management of infected early postoperative lymph leak in the groin

Lymph leak from a groin incision following vascular procedures on the fem oral vessels can be a difficult postoperative management problem. Eight pa tients (of 198 undergoing vascular reconstructions involving the femoral vessels) developed 9 lymph leaks (4.5%) through the groin skin incision in the first post operative week. Three patients (38%) had a synthetic prosthesis and 5 (62%) had autogenous saphenous vein grafts. Initially, the authors treated the patients with intravenous antibiotics, bed rest, and sterile occlusive dressings. The lym phorrhea persisted in all patients, and serial cultures of the draining lymph became positive within fourteen days postoperatively. Surgical management consisted of radical debridement of the wound and rotation of a muscle flap to cover the vascular repair. The wounds were left open to granulate, then split- thickness skin grafts were applied. During a follow-up period ranging from eighteen to thirty-six months, there was no evidence of graft infection, recurrent l...