Maser B, Vedder N, Rodriguez D, Johansen K
Division of Vascular Surgery, University of Washington Affiliated Hospitals, Seattle, USA.
Arch Surg. 1997 May;132(5):522-5; discussion 525-6. doi: 10.1001/archsurg.1997.01430290068013.
To review the safety, durability, and efficacy of sartorius myoplasty in the treatment of localized vascular prosthetic graft infection in the groin.
Case series.
University teaching hospitals.
Fourteen patients with 15 exposed, eroded, or overtly infected prosthetic vascular grafts in the groin, treated during 7 years.
Groin exploration for delineation of the extent of vascular graft infection, followed by extensive perigraft debridement, then dissection and rotation of the ipsilateral sartorius muscle to cover the involved graft.
Healing of groin wound with preservation of vascular graft function, limb salvage, length of hospital stay, impact of specific wound bacteria, and evidence of long-term hip dysfunction.
During a mean hospital stay of 8.7 days, sartorius myoplasty was accomplished with 20% morbidity. Hip flexor function was initially impaired in all 14 patients, but functional deficit was negligible at late assessment. During mean follow-up of 36 months, all wounds were healed, and all limbs were salvaged. Two late deaths occurred, and 2 limbs were ultimately amputated due to progressive loss of vascular outflow.
Sartorius myoplasty is a simple, safe, durable, and effective technique for preservation of locally infected or exposed vascular grafts in the groin.
回顾缝匠肌成形术治疗腹股沟区局限性人工血管移植物感染的安全性、耐用性和疗效。
病例系列。
大学教学医院。
14例患者，共15处腹股沟区人工血管移植物出现暴露、侵蚀或明显感染，治疗时间长达7年。
探查腹股沟以明确血管移植物感染范围，随后进行广泛的移植物周围清创，然后解剖并旋转同侧缝匠肌以覆盖受累移植物。
腹股沟伤口愈合且血管移植物功能得以保留、肢体保全情况、住院时间、特定伤口细菌的影响以及长期髋关节功能障碍的证据。
平均住院时间为8.7天，缝匠肌成形术的并发症发生率为20%。14例患者的髋屈肌功能最初均有受损，但在后期评估时功能缺陷可忽略不计。平均随访36个月时，所有伤口均愈合，所有肢体均得以保全。发生2例晚期死亡，2例肢体最终因血管流出道逐渐丧失而截肢。
缝匠肌成形术是一种简单、安全、耐用且有效的技术，可用于保全腹股沟区局部感染或暴露的血管移植物。
