Management of Draining Wounds in Vascular Surgery

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Abstract
Drainage from a wound overlying a prosthetic vascular graft is a source of major concern in vascular surgery, often heralding serious complications in cluding hemorrhage, thrombosis or infection. Despite improvement in graft design and surgical technique, healing problems are reported to occur in about 2 % of cases.1 Perigraft fluid collections may be secondary to infection, ac cumulation of lymph or serum, to failure of the graft material or to allergy to graft material or some foreign substance adherent to its surface.1-6 The management of draining wounds remains controversial. Early experi ence with infected grafts treated locally was uniformly unsuccessful, and resulted in significant morbidity and mortality.1 This led to the classic teaching that grafts underlying infected wounds must be removed and replaced through extra anatomic pathways. Recently local treatment has received renewed interest in an attempt to salvage an otherwise functioning graft.2,3 We have utilized an early aggressive local approach to draining wounds with salvage of grafts that would otherwise have been removed and a considerable decrease in morbidity.