Intra-Dermal Absorbable Suture in the Groin Incision Associated with Less Groin Surgical Site Infections than Trans-Dermal Sutures in Vascular Surgical Patients.

BACKGROUND The groin surgical site is frequently infected in vascular surgical procedures. Our aim was to evaluate the relation of skin closure methods and groin incision infection after vascular operations involving femoral artery exposure. METHODS In this retrospective patient record study, patient files of all consecutive patients admitted for a vascular procedure to the Turku University Hospital Department of Vascular Surgery during 2015-2016 were evaluated. Patients with an isolated groin surgical site because of femoral artery exposure (256) were included in the study. Patient demographics, details of the operations, and follow-up data were collected from the electronic patient data record. Statistical analyses were performed using a multi-variable model. RESULTS Altogether, 330 groin incisions were performed for 256 patients. Of all incisions, 262 (79.4%) were closed using intra-dermal absorbable suture; trans-dermal sutures were used in 68 (20.6%) incisions. Groin infections occurred in 24 (9.2%) patients after skin closure with intra-dermal absorbable suture and in 17 (25.0%) cases after trans-dermal sutures. Incisions that were closed using trans-dermal sutures were 3.5 times as likely to have an infection as those closed using intra-dermal sutures (odds ratio 3.5, confidence interval 95% 1.6 to 7.6, p = 0.002). CONCLUSION Present data suggest that groin incision closure with intra-dermal absorbable suture is associated with groin incision infections compared with those incisions closed with trans-dermal sutures.

[1]  C. Wahlgren,et al.  Healthcare-associated infections after lower extremity revascularization. , 2013, European journal of vascular and endovascular surgery : the official journal of the European Society for Vascular Surgery.

[2]  M. Venermo,et al.  Effect of Triclosan-Coated Sutures on the Incidence of Surgical Wound Infection After Lower Limb Revascularization Surgery: A Randomized Controlled Trial , 2012, World Journal of Surgery.

[3]  M. Mell,et al.  Predictors of surgical site infection after open lower extremity revascularization. , 2011, Journal of vascular surgery.

[4]  M. Reinikainen,et al.  Supplemental Postoperative Oxygen in the Prevention of Surgical Wound Infection after Lower Limb Vascular Surgery: A Randomized Controlled Trial , 2011, World Journal of Surgery.

[5]  V. Kiviniemi,et al.  Surgical Wound Infections after Vascular Surgery: Prospective Multicenter Observational Study , 2010, Scandinavian journal of surgery : SJS : official organ for the Finnish Surgical Society and the Scandinavian Surgical Society.

[6]  F. Moll,et al.  Risk Factors for Surgical-Site Infection Following Common Femoral Artery Endarterectomy , 2009, Vascular and endovascular surgery.

[7]  S. Berceli,et al.  Impact of an absorbent silver-eluting dressing system on lower extremity revascularization wound complications. , 2007, Annals of vascular surgery.

[8]  J. Mandrekar,et al.  Prosthetic vascular graft infection: a risk factor analysis using a case-control study. , 2006, The Journal of infection.

[9]  D. Wipke-Tevis,et al.  Vascular infections: medical and surgical therapies. , 1999, The Journal of cardiovascular nursing.

[10]  R. X. Murphy,et al.  Optimal Management of Inguinal Vascular Graft Infections , 1994, Annals of plastic surgery.

[11]  J. P. Elliott,et al.  Infection in Arterial Reconstruction with Synthetic Grafts , 1972, Annals of surgery.