Wound Complications Following Vascular Reconstructive Surgery

Wound healing problems are the most frustrating and dangerous possible complications associated with vascular reconstructive surgery. Wound healing complications are related to age, advanced atherosclerotic disease, tissue ischemia, lengthy incisions, and the multiple comorbid medical conditions that routinely exist in the vascular patient population. However, the significance of wound complications in patients undergoing vascular reconstruction has received only minor emphasis in the literature. Fortunately, most wound complications are superficial and are not limb-nor graft-threatening, causing only inconvenience and additional expense to the patient. In the most severe cases, wound have the potential to involve the underlying graft, either prosthetic or autogenous, which may often lead to hemorrhage or graft occlusion with resultant loss of life or limb. This chapter reviews the classification, incidence, and etiological factors responsible for wound complications in different anatomical locations as well as methods of prevention and treatment, including alternative operative techniques, that may have a favorable impact upon the frequency of wound complications following vascular reconstructive surgery.