Muscle Flaps in the Management of Vascular Grafts in Contaminated Wounds: An Experimental Study in Dogs

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Abstract
This study evaluates in an animal model the efficacy of muscle flaps in protecting the fabric vascular prosthesis when placed in contaminated wounds. A total of 20 adult mongrel dogs received a 2-cm interpositional polytetrafluoroethylene (PTFE) graft to each femoral artery at the groin level. During the surgical procedure, the wounds were inoculated with a Staphylococcus aureus suspension containing either 1 × 104 or 1 × 105 organisms per milliliter. In half the animals, the grafts were wrapped with a distally based sartorius muscle flap before a standard two-layer closure was completed. One month after the surgery, all the animals were sacrificed and quantitative cultures were performed of the grafts and wounds. The muscle flaps were capable of protecting the vascular prosthesis with inoculums up to 1 × 104 organisms (p < 0.05), but at greater bacterial contamination their efficacy was no longer significant.

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