[Plastic Surgical Management and Clinical Practice-based Algorithm for Coverage of Inguinal Defects after Vascular Prosthesis Infection].

Abstract

Infections involving vascular prostheses in the groin region are a major surgical challenge, associated with substantial morbidity and mortality rates. The complex anatomical structures and high density of bacterial colonisation considerably complicate their surgical management. Consequently, reconstructive therapy demands individualised and interdisciplinary strategies to achieve optimal outcomes.A systematic search was conducted using PubMed and the Cochrane Library to collect and evaluate current evidence and recommendations regarding the reconstructive management of infected vascular prostheses. The developed algorithm incorporated essential factors, such as defect size, infection severity, and patient-specific characteristics to guide therapeutic decision making.Pedicled flap techniques, particularly those employing the M. sartorius or M. gracilis, are rapid and reliable reconstructive solutions - due to their robust vascular supply. In cases of larger defects, the transverse myocutaneous gracilis (TMG), Rectus femoris, and anterolateral thigh (ALT) flaps proved to be suitable alternatives. Prophylactic use of pedicled flaps was associated with a reduction in postoperative complications, particularly in high-risk patientsThe surgical management of deep groin infection requires meticulous individualised and interdisciplinary planning and plastic reconstructive experience. The proposed algorithm provides a structured and evidence-based framework to improve healing rates and minimise the risk of complications.