[Thigh muscle flaps for postoperative inguinal wound complications in vascular surgery : Sartorius muscle versus rectus femoris muscle].

2020 
Background Inguinal wound complications often cause postoperative morbidity and also mortality following vascular surgical interventions. The aim of this study was to report experiences and a comparison of the outcomes using rectus femoris muscle flaps (RFF) and sartorius muscle flaps (SMF). Material and methods A retrospective study was performed at two locations of a cross-border vascular center and all muscle flap interventions performed at the two centers within the vascular surgery department were reviewed. Primary outcomes were muscle flap survival, graft salvage and major amputations. Results A total of 44 RFFs were performed in 39 patients (mean age 67 years, 73% males) and 25 SMFs in 24 patients (mean age 64 years, 76% males). Wound infections were the most common indications for muscle flap reconstruction. At a mean follow-up of 24 months (±24) and 17 months (±20), respectively, comparable flap survival rates (91% vs. 84%), wound healing rates (72% vs. 83%), graft salvage (65% vs. 73%) and amputation rates (9% vs. 8%) were found. Conclusion Muscle flap reconstruction is an effective way to cover groin defects resulting from deep wound infections after vascular surgery, achieving good results in a high-risk group of patients. No differences were found between SMF and RFF regarding amputation and graft loss. Both techniques can be safely performed, depending on the preference and experience of the surgical team. The RFF technique should be preferentially used to cover large tissue defects, whereas the SMF procedure can be preferred to cover smaller defects in the groin.
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