Relative Outcomes of Flap-Based Reconstruction and Incisional Negative-Pressure Wound Therapy for Groin Coverage in the Setting of Vascular Intervention

Kaamya Varagur, MPhil1; Karim Saoud, BS1; Janessa Sullivan, BA1; Sai L. Pinni, BS1; Gary B. Skolnick, MBA1; Justin M. Sacks, MD, MBA1; Amy F. Kells, MD, PhD1; Joani M. Christensen, MD1

1. Washington University in St. Louis Division of Plastic and Reconstructive Surgery, Department of Surgery, St. Louis, MO

• Vascular operations in the groin face high

rates of wound complications that

threaten both the underlying vascular

reconstruction and limb

• Pedicled rectus femoris or sartorius

muscle flaps and incisional negativepressure

wound therapy (iNPWT) can be

used for groin coverage either

prophylactically, or to manage

complications such as groin infection.

• Prior work has not studied the relative use

of these flaps in prophylactic contexts,

and has not examined the benefit of

iNPWT alone

Aims

• To compare outcomes of sartorius muscle flap, rectus femoris muscle flap, and

iNPWT alone for prophylactic groin coverage following vascular surgery

• To examine relative outcomes of rectus femoris versus sartorius muscle flap

when indicated for groin complications

Methods

Retrospective chart review of

demographics, comorbidities,

interventions, and complications

• Bivariate and multivariate Firth

logistic regressions

Results

• Rectus femoris flap coverage was a predictor of lower odds

of postoperative infection on multivariate regression

• Rectus femoris flap coverage was associated with higher rates

of incisional breakdown/dehiscence than sartorius flaps

Conclusions

Prophylactic

• Rectus femoris flap use is associated with significantly lower

infection risk compared to iNPWT alone

• Sartorius flap use also trended toward lower infection risk

compared to iNPWT alone, though this did not reach

significance

• Protection of vascular procedure is comparable between

coverage options

Groin Complications:

• Rectus femoris flaps may be associated with elevated rates of

incisional breakdown compared to sartorius flaps

• Comparable vascular salvage rates between flap options