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Methods: A retrospective analysis of prospectively collected data from a single institution (Stony Brook University Medical Center) using the Vascular Quality Initiative database was performed. The research protocol was defined prior to initiating data collection. Included were consecutive pa- tients who underwent groin dissection with either electrocautery (group A) or ultrasonic devices (group B) during the following procedures: endovascu- lar aortic aneurysm repair, thoracic endovascular aortic aneurysm repair, lower extremity bypass, or hybrid peripheral vascular intervention. In-hospi- tal and outpatient records were reviewed to capture postoperative surgical site complications, and clinical outcomes were compared between the groups. Results: Over a 24-month period, 233 patients underwent peripheral vascular interventions that required 346 groin dissections. There were no significant differences in the risk profile of the patients between group A (n ¼ 135) and group B (n ¼ 98). Wound complications (hematoma, infec- tion, dehiscence, lymphocutaneous fistula, and seroma/lymphocele) occurred significantly less often in the ultrasonic group (group B: 7.2%) compared with the electrocautery group (group A: 28.5%; P < .0001). When looking at specific wound complications, use of the ultrasonic energy device significantly decreased the rate of lymphatic complications (2.1% vs 14.6%; P < .01) and wound dehiscence (0% vs 7%; P ¼ .01). Conclusions: The use of the ultrasonic energy device (Harmonic), when compared with electrocautery (Bovie) in surgical dissection of the groin, is associated with a lower rate of wound complications, specifically lymphatic leaks and wound dehiscence. Routine use of this alternative tool may help decrease surgical site complications in this particularly vulner- able area. |
