The incidence of infected femoral artery pseudoaneurysms is likely to increase with increasing numbers of femoral artery interventions.
Methods:
Case report and review of literature.
Results:
We present a case of dehiscence of a vein patch repair of an infected femoral pseutoaneurysm treated with ligation of vessels and coverage by rectus abdominis muscle flap.
Conclusion:
We consider the use of this flap as a good second line option for the coverage of exposed femoral vessels, in the presence of sepsis, particularly when the external iliac artery has been ligated.
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References
1.
GomesMN, SpearSL. Pedicled muscle flaps in the management of infected aortofemoral grafts. Cardiovasc Surg, 1994; 2:70–77.
2.
ThomasWO3rd, ParrySW, PowellRW, McGeeGS, RodningCB. Management of exposed inguinofemoral arterial conduits by skeletal muscular rotational flaps. Am Surg, 1994; 60:872–880.
3.
WiemerDR. The rectus abdominis flap for exposed vascular grafts of the lower extremity. Plast Reconstr Surg, 1994; 93:889–890.
4.
AlkonJD, SmithA, LoseeJE, et al. Management of complex groin wounds: Preferred use of the rectus femoris muscle flap. Plast Reconstr Surg, 2005; 115:776–783.
5.
Perez-BurkhardtJL, Gonzalez-FajardoJA, CarpinteroLA, MateoAM. Sartorius myoplasty for the treatment of infected groins with vascular grafts. J Cardiovasc Surg (Torino), 1995; 36:581–585.
6.
ColwellAS, DonaldsonMC, BelkinM, OrgillDP. Management of early groin vascular bypass graft infections with sartorius and rectus femoris flaps. Ann Plast Surg, 2004; 52:49–53.
7.
ArmstrongPA, BackMR, BandykDF, JohnsonBL, ShamesML. Selective application of sartorius muscle flaps and aggressive staged surgical debridement can influence long-term outcomes of complex prosthetic graft infections. J Vasc Surg, 2007; 46:71–78.
8.
GrahamRG, OmotosoPO, HudsonDA. The effectiveness of muscle flaps for the treatment of prosthetic graft sepsis. Plast Reconstr Surg., 2002; 109(1):108–113.
9.
KaufmanJL, ShahDM, CorsonJD, SkudderPA, LeatherRP. Sartorius muscle coverage for the treatment of complicated vascular surgical wounds. J Cardiovasc Surg (Torino), 1989; 30:479–483.
10.
MeyerJP, DurhamJR, SchwarczTH, SawchukAP, SchulerJJ. The use of sartorius muscle rotation-transfer in the management of wound complications after infrainguinal vein bypass: a report of eight cases and description of the technique. J Vasc Surg, 1989; 9:731–735.
11.
SchutzerR, HingoraniA, AscherE, et al. Early transposition of the sartorius muscle for exposed patent infrainguinal bypass grafts. Vasc Endovascular Surg, 2005; 39:159–162.
12.
BucklandA, PanWR, DharS, et al. Neurovascular anatomy of sartorius muscle flaps: Implications for local transposition and facial reanimation. Plast Reconstr Surg, 2009; 123:44–54.
13.
WuLC, DjohanRS, LiuTS, et al. Proximal vascular pedicle preservation for sartorius muscle flap transposition. Plast Reconstr Surg, 2006; 117:253–258.
14.
KhalilIM, SudarskyL. Sartorius muscle “twist” rotation flap: An answer to flap necrosis. J Vasc Surg, 1987; 6:93–94.
15.
AraiT, IkutaY, IkedaA. A study of the arterial supply in the human rectus femoris muscle. Plast Reconstr Surg, 1993; 92:43–48.
16.
TopelI, BetzT, UhlC, SteinbauerMG. The impact of superficial femoral artery (SFA) occlusion on the outcome of proximal sartorius muscle transposition flaps in vascular surgery patients. J Vasc Surg, 2011; 53:1014–1019.
17.
HortaR, FilipeR, CostaJ, et al. Vertical rectus abdominis musculocutaneous flap: A good option for reconstruction of large inguinofemoral defects with exposure of the femoral vessels: brief report focusing on management of advanced vulvar carcinoma. Int J Gynecol Cancer, 2011; 21:565–567.
18.
NelsonRA, ButlerCE. Surgical outcomes of VRAM versus thigh flaps for immediate reconstruction of pelvic and perineal cancer resection defects. Plast Reconstr Surg, 2009; 123:175–183.
19.
KhalilHH, El-GhoneimyA, FaridY, et al. Modified vertical rectus abdominis musculocutaneous flap for limb salvage procedures in proximal lower limb musculoskeletal sarcomas. Sarcoma, 2008; 2008:781408.
