ABSTRACT

To present early and midterm results of our patients treated using gracilis muscle flap for prosthetic vascular graft (PVG) infections located in the femoral region.

Eight patients admitted to our clinic between January 2012 and August 2016 and treated using gracilis muscle flap owing to PVG infection in the femoral region were included in the present study. The contents of hospital files of the patients with PVG infection were thoroughly evaluated and recorded. Additionally, routine biochemical tests, Doppler ultrasonography, computed tomography; angiography wound site and blood culture results pertaining to the patients were also evaluated in detail.

In the present study, we treated 8 patients (5 males and 3 females) using gracilis muscle flap. Their average age was 58 ± 8.9 (39-67) years. All the patients suffered from the graft infections spreading to the subcutaneous tissues (Szilagyi grade III). While the prosthetic grafts used in 6 patients were Polytetrafluoroethylene (PTFE), they were Dacron in 2 patients. Moreover, 6 patients developed infections in the early period while 2 patients showed infections in the late period. The pathogens causing graft infections were identified to be staphylococcus aureus in 3 patients, staphylococcus epidermidis in 1 patient and polymicrobial agents in 4 patients. Furthermore, while graft occlusion was noted in one of the patients, a 2 cm opening was noticed distal to the skin incision in another patient. There was no loss of limb and mortality in any of the patients we presented here and more importantly they were fully recovered.

The present results indicate that gracilis muscle flap reconstruction in PVG infections is an effective and feasible alternative to cover the area exposed to infection and rescue prosthetic graft material.