LINK Scientific Content – Congress Abstract

Combined NPWT and Omental Flap for prosthetic femoropopliteal bypass Graft salvage

Scientific Content

Combined NPWT and Omental Flap for prosthetic femoropopliteal bypass Graft salvage

Congress Abstract
LINK Congress 2019, NPWT
Publication Year
Alexandru Carâp et al.
Approx. reading time
5 min (1 pages)


Aim To highlight the use of negative pressure wound therapy (NPWT) for the treatment of surgical site infection (SSI) after emergency vascular reconstruction with a synthetic prosthesis.

The risk to life and limb of these infections and subsequent sepsis poses management challenges in the treatment of infection, sepsis source control, and management of the exudate. The case also highlights approach problems in applying NPWT in the groin region and other transition zones.


We reviewed the case of a young adult male admitted to our department with an expanding right groin hematoma, emergent vascular reconstruction, and SSI and sepsis.


The patient was admitted for a large hematoma of the right medial thigh with localized pain. Twelve hours after admission the patient became hypotensive, tachycardic and a vascular fistula developed over the area of the hematoma. Immediate surgery was performed and found a ruptured superficial femoral artery aneurism for which hemostasis and a proximal femoropopliteal bypass with a no. 8 PTFE were performed.

On postoperative day 9 the patient developed sepsis from an SSI. Source control was achieved with large skin and muscle debridement followed by covering the vascular prosthesis and the operative site with an omental pedicle obtained by laparotomy. NPWT was initiated over the omentum and the septic phenomena resolved in 48 hours. Granulation tissue started to develop over muscle tissue but was slow to form over the omental pedicle. Multiple skin grafts were necessary. Three years into follow-up the patient exhibits normal function of the right lower limb with slight edema.


The management of infected vascular prostheses remains challengeing. Management often leads to excision of the grafts and limb loss. The use of an omental pedicle combined with exudate management with NPWT led to excellent source control and to a resolution of sepsis.

Clinical relevance

The combined use of omental pedicles and NPWT can lead to salvage of infected synthetic prostheses after SSI of bypass graft procedures.


Acosta S, Björck M, Wanhainen A. Negative-pressure wound therapy for prevention and treatment of surgical-site infections after vascular surgery. Br J Surg. 2017 Jan;104(2):e75-e84.


Alexandru Carâp et al.
Carol Davila, Unuiversity of Medicine and Pharmacy, Surgery, Bucharest, Romania, St Pantelimon, Emergency Clinical Hospital, Surgery, Bucharest, Romania

Read more about these topics

Get access to over 200 scientific abstracts, publications, webinars and E-learning to expand your knowledge of wound management.

You might be interested in