The Effect of Vacuum Assisted Closure Treatment on Postsurgical Lower Extremity Groin Wounds and Secondary Lymphatic Complications

Abstract

Objective: Delayed wound closure and secondary lymphatic problems prolong hospital stay. The femoralexposure is one of the most commonly used access way for the cardiac and peripheral vascular surgery. In thisstudy, we investigated the effect of vacuum-assisted closure (VAK) treatments on the recovery time in non-healinggroin wounds after femoral vessel exposure and secondary lymphatic problems in the lower extremity.Materials and Methods: In this retrospective study, we examined 335 patient’s hospital records who had groinincision for access to femoral vessels in major vascular surgeries performed in our clinic in the last two years. We observed non healing inguinal wounds and lymphatic problems such as secondary lymphorrhea, lymphocele orlymphedema in 32 of these patiens (9.5%). The patients with insufficient wound healing in the first 10 dayspostoperatively and associated lymphatic disorders were primarily treated with surgical debridement of the femoralincision, ligation of lymphatics and removal of lymphocele. Afterwards, only surgical debridement and woundcare was used in 16 patients (Group 1) and additional to these therapies vacuum assisted closure (VAC) deviceused in 16 patients (Group 2). Demographic data, risk factors and duration of the treatment for wound healing inboth groups were compared.Results: There was no difference in demographic characteristics between groups. When comorbid diseases werecompared, there were no difference between the groups. There was no difference with regard to etiological riskfactors for wound site complications such as prosthetic grafts in the femoral region, hypoalbuminemia, recurrentoperations. But there were more obese patients in Group 2. The mean wound healing time was shorter in Group 2but it was not statistically significant.Conclusion: The basic treatment of postsurgical secondary lymphedema and groin wound healing problem isdebridement and optimal surgical wound care. VAC usage enhances the drainage of the lymphatic flow of lowerextremity and strengthen wound base by granulation tissue formation. VAC therapy may be an effectivetherapeutic option to accelerate healing of lower extremity femoral wounds and secondary lymphedema.