Clinical outcome and microvascular blood flow in VAC® - and Sorbalgon® -treated peri-vascular infected wounds in the groin after vascular surgery - an early interim analysis

Abstract

Vacuum-assisted wound closure (VAC(®)) therapy is considered to be superior to conventional dressings in the treatment of peri-vascular groin infections after vascular surgery at our department. Therefore, we performed an early interim analysis of the clinical outcomes in these seriously ill patients at risk of amputation and death. Patients were randomised to either VAC(®) (n = 5) or Sorbalgon(®) (n = 5; best alternative treatment) therapy after surgical debridement. Non-invasive, laser Doppler perfusion imaging (LDPI) studies of the skin adjacent to the undressed wound were performed after 14 days of wound treatment. There was no difference in LDPI values in VAC(®) versus Sorbalgon(®) treated patients (P = 0·46). One patient in the VAC(®) group suffered from two re-bleeding episodes, leading to vascular resection and transfemoral amputation and in the Sorbalgon(®) group two had a complete wound healing time of more than 4 months and one had a visible interposition bypass graft in the groin after 1 month of treatment. No patient died of the groin infection. Although not statistically proven, fewer wound treatment failures were recorded in the VAC(®) group, justifying this early interim analysis. LDPI studies were feasible.

Keywords: Groin infection; Laser Doppler blood flow; Negative pressure wound therapy; Vacuum-assisted wound closure; Vascular surgery.

Figure 1

Example of a laser Doppler perfusion imaging study of an undressed wound in the right groin after vascular surgery. The patient legs are directed upwards. The right image represents the photographic presentation of the measuring area with the regions of interest drawn in the image. The left image is the corresponding blood flow image.