Prophylactic use of wound care products as a barrier in high-risk vascular surgery patients with underlying prosthetic materials prone to deep space infections

Abstract

Objectives

Prosthetic infection is a feared complication following vascular surgery and is associated with significant morbidity. Recently, biologic wound care adjuncts have been used more given their advantageous effects on wound healing. The goal of this study is to evaluate the outcomes of patients who underwent placement of biologic wound care products over prosthetics with the goal of observing reduced deep dehiscence involving the prosthetic or prosthetic infections.

Results

From June 1, 2023 to June 26, 2024, 13 patients met criteria for inclusion. Ten of the 13 (77%) involved placement of a prosthetic in a revision field as the primary indication; two of the 13 (15%) involved high-risk prosthetics in either obese fields or in fields with little soft tissue coverage over a prosthetic implant (1/13, 8%). Overall, there was one graft infection (8%) and there were no deep dehiscence occurrences which involved the underlying prosthetic. The graft infection occurred after a failed surgical thrombectomy, which involved a surgical cutdown at a new surgical site over a femoral-tibial prosthetic bypass in a patient had previously demonstrated a fully healed wound with no indication of wound infection. No other patients suffered a deep dehiscence of their wound involving the prosthetic or graft infection.

Conclusion

This study demonstrates the feasibility of prophylactic use of biologic products with the hope of preventing deep space infection involving underlying prosthetics. More studies are needed to evaluate this technique; however, these early results are promising.