Groin wound infection after vascular exposure (GIVE) multicentre cohort study

Abstract

Surgical site infections (SSIs) of groin wounds are a common and potentially preventable cause of morbidity, mortality, and healthcare costs in vascular surgery. Our aim was to define the contemporaneous rate of groin SSIs, determine clinical sequelae, and identify risk factors for SSI. An international multicentre prospective observational cohort study of consecutive patients undergoing groin incision for femoral vessel access in vascular surgery was undertaken over 3 months, follow-up was 90 days. The primary outcome was the incidence of groin wound SSI. 1337 groin incisions (1039 patients) from 37 centres were included. 115 groin incisions (8.6%) developed SSI, of which 62 (4.6%) were superficial. Patients who developed an SSI had a significantly longer length of hospital stay (6 versus 5 days, P = .005), a significantly higher rate of post-operative acute kidney injury (19.6% versus 11.7%, P = .018), with no significant difference in 90-day mortality. Female sex, Body mass index≥30 kg/m 2 , ischaemic heart disease, aqueous betadine skin preparation, bypass/patch use (vein, xenograft, or prosthetic), and increased operative time were independent predictors of SSI. Groin infections, which are clinically apparent to the treating vascular unit, are frequent and their development carries significant clinical sequelae. Risk factors include modifiable and non-modifiable variables.

The PERCEIVE quantitative study: PrEdiction of Risk and Communication of outcome following major lower-limb amputation: protocol for a collaboratiVE study

“…The study has been disseminated by VERN via email contacts and social media; a method successfully used in previous studies delivered by VERN 13–16 . Based on current interest, it is predicted that over 40 centres will contribute data to the study.…”

“…PERCEIVE is an international, multicentre prospective observational cohort study coordinated by the Centre for Trials Research, Cardiff University and disseminated by the Vascular and Endovascular Research Network (VERN) 11 , 12 . The collaborative methodology has been used successfully by VERN previously 13–16 .…”

“…Data completeness will be quantified following the initial data-collection period. Individual patient records with less than 95 per cent completeness of mandatory datapoints will be returned to the centre for completion of data collection; if this is not possible the patient will be excluded from analysis as per previous international collaborative studies 13 , 34 , 35 . All centres will be required to validate data accuracy in 20 per cent of their uploaded cases (randomly selected); 25 per cent of datapoints (randomly selected) per case will be validated equating to 5 per cent of total datapoints captured in the study.…”

Augmented Reality in Vascular and Endovascular Surgery: Scoping Review

“…Complications in vascular surgery such as wound infections are associated with the extent of dissection, size of the wound, and duration of the surgery [ 4 ]. Anatomical localization with AR may help in reducing complications and improving overall outcomes.…”

Groin surgical site infection incidence in vascular surgery with intradermal suture versus metallic stapling skin closure: A study protocol for a pragmatic open-label parallel-group randomized clinical trial (VASC-INF trial)

“…[ 5 – 7 ] The groin is the most common infection site in vascular surgery since it is a folding area full of lymph glands and located close to genitalia. [ 8 ] SSI incidence after vascular surgery has dropped from almost 30% [ 9 ] in the 1980s to 20% [ 10 ] in the 2000s and currently is approximately 10%, [ 11 ] which may be due to improvements in asepsis measures and operative time.…”