Prosthetic vascular graft infection--defect covering with delayed vertical rectus abdominis muscular flap (VRAM) and rectus femoris flap.

Prosthetic vascular graft infection is associated with high rates of morbidity and mortality. When infections lead to an open exposure of vascular prosthesis special techniques may be necessary to cover tissue defects in regions with often very poor circulation/perfusion conditions. Even when there are large tissue defects associated with vascular prosthetic graft infections and exposure of prosthesis local cure can be achieved after radical debridement and defect coverage through transposition of myocutaneous flaps. The cases of two patients with open exposure of prosthesis in the groin who had been successfully treated by delayed vertical rectus abdominis muscular flap (VRAM) or rectus femoris rotation are presented. The contralateral VRAM myocutaneous flap is an excellent alternative if local measures fail to close large groin defects with exposed prosthesis. In addition the delayed flap rotation offers a greater safety in conditioning the vascularity of the flap.