L.D. Jeong1, T.D. Zhang1, M.P. Bald1, J.P. Moody1, L. Curwick2, A.W. Beck3, R.P. Myers2 1University of Alabama at Birmingham, Heersink School Of Medicine, Birmingham, AL, USA 2University of Alabama at Birmingham, Division Of Plastic Surgery, Birmingham, AL, USA 3University of Alabama at Birmingham, Division Of Vascular Surgery And Endovascular Therapy, Birmingham, AL, USA
Introduction:
The use of absorbable antibiotic beads (AAB) in vascular wounds and reconstructive procedures has been associated with reduced rates of reoperation, suggesting potential benefits for patients undergoing complex wound management. Limited literature exists on the efficacy of AAB use at the time of groin reconstruction with muscle flap coverage of vascular reconstructions. This retrospective analysis aims to evaluate the outcomes of patients who received AAB during groin reconstruction performed with muscle flap coverage following a vascular bypass procedure at a large tertiary-care hospital.
Methods:
A retrospective review of patients who underwent vascular bypass surgery followed by groin reconstruction by the Plastics and Reconstructive Surgery service from January 2018 to March 2024 at a single institution was conducted. This study analyzed patients who experienced complications following primary closure with prosthetic, autologous vein, or cryopreserved bypass procedures, leading to a need for subsequent muscle flap coverage. Patients were grouped by whether vancomycin AAB were placed during the muscle flap/groin reconstruction. Variables evaluated included demographics, reoperations, readmissions, and postoperative complications. Data was primarily analyzed using t-tests and Chi-square tests with significance set at 0.05.
Results:
A total of 52 patients met our inclusion criteria, of which 17 patients (32.7%) received AAB. The total cohort comprised 36 male and 16 female patients who underwent vascular bypass procedures using synthetic grafts (n=30), autologous vein grafts (n=13), cadaveric allografts (n=7), and unspecified grafts (n=2). The AAB cohort had lower rates of readmission (0%) than the control group (20%) as well as fewer reoperations (5.9% vs. 51.4%) (P=0.0475 and P=0.0017, respectively). No postoperative surgical site infections (SSI) occurred in the AAB cohort compared to 34.3% of the control group (P=0.0049), as shown in Table 1. Additionally, chronic wound care was necessary for 48.6% of control group cases and unnecessary for all patients who received AAB (P=0.0003).
Conclusion:
The use of absorbable antibiotic beads with muscle flap coverage for complex groin wounds led to significantly improved patient outcomes. Reduced rates of reoperations, readmissions, and SSI indicate that antibiotic beads may effectively lower postoperative complications and improve overall patient recovery in groin reconstruction procedures.