Vacuum assisted wound closure in postoperative periprosthetic groin infections: a new gold standard?

Aim. This study was designed to control the results of conservative treatment using vacuum assisted wound closure (VAWC) applied exclusively to cases of deep groin infections with involvement of alloplastic graft material. Methods. During a 2 year period 10 patients with 11 deep inguinal infections involving alloplastic graft material were treated with supportive VAWC. Intraoperative management included extensive debridement, sartorius myoplastic and VAWC application. A retrospective case-note review was performed. Variables comorbidity, surgical management of the infection, microbiological results, complications and Doppler results were analysed. Results. Six early graft infections (<30 days after implantation) and 5 late infections were treated. In 3 cases (27.3%) the infected graft material was replaced by a silver-coated Dacron prosthesis. The mean duration of VAWC was 16±7.7 days; postoperative mean hospital stay was 25.3±8.5 days. Mean postoperative follow-up was 13.1 months with no procedure-related mortality. Conclusion. Even in the presence of synthetic vascular graft material, negative pressure therapy can greatly simplify challenging wound healing problems under maintenance of the alloplastic grafts. These preliminary results demonstrate the safety and effectiveness of VAWC for the treatment of deep alloplastic graft infections.