Surgical Treatment of Prosthetic Graft Infection Complicated with Lymphorrhea: Vacuum-assisted Closure (VAC) Therapy and Sartorius Muscle Flap Coverage

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  • リンパ漏を伴った鼠径部人工血管感染に対する外科治療経験
  • VAC 療法と縫工筋弁充填による人工血管温存

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After vascular procedures, lymphatic complications at groin sometimes may lead to devastating circumstance, such as prosthetic graft infection. Here, we report a case of early graft infection subsequent to lymphorrhea managed with vacuum-assisted closure (VAC) therapy and sartorius muscle flap coverage. A 78-year-old man had surgical repair of an abdominal aortic aneurysm via laparotomy and bilateral oblique femoral incisions. Seven days after the operation, he presented serous lymphatic fluid from right femoral incision followed by prosthetic graft infection with high fever. After initial wound debridement, the wound was treated by VAC therapy. His lymph leak ceased after 7 days of VAC therapy. Although the wound was clean and clear of infection, the dead space around the exposed prosthetic graft was too large. So we performed sartorius muscle flap coverage in order to eliminate the dead space and avoid prolonged hospital stays. The wound was healed completely and the lymph leak was not recurred. On postoperative day 58, he discharged from hospital in good condition. We recommend consideration of VAC therapy and sartorius muscle coverage for prosthetic graft infection complicated with groin lymphorrhea as an alternative to many modes of conventional treatment.

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