One patient with poor healing of sinus after implant of vascular prosthesis due to infected abdominal aortic aneurysms treated with negative pressure wound therapy combined with local flap

In February 2018, a 67-year-old male patient with infected abdominal aortic aneurysm was admitted to the Department of Vascular Surgery of Yantai Yuhuangding Hospital Affiliated to Qingdao University Medical College. After admission, abdominal aortic endovascular exclusion surgery, right iliac artery-double femoral artery vascular bypass+ infected abdominal aortic aneurysmectomy+ stent removal surgery, and active anti-infective treatment were performed in the department of vascular surgery. Seven days after the vascular prosthesis bypass surgery, the surface skin of the vascular prosthesis of the patient was red and swollen, and there was a purulent discharge, which was diagnosed as poor healing of sinus of vascular prosthesis. Surgeons of our department and the department of vascular surgery performed incision and debridement of sinus of vascular prosthesis+ vacuum sealing drainage (VSD) in the early stage under local anesthesia. After the local infection was controlled and wound blood supply was improved, stage Ⅱ surgery of resection of sinus of vascular prosthesis+ vascular prosthesis partial diversion+ local flap propulsion under general anesthesia was performed. The incision healed well after surgery, and the patient was discharged smoothly. During the follow-up of 6 months, the patient′s flap was in good shape, and the wound was healed. This case prompts that after the diagnosis of infected abdominal aortic aneurysm vascular sinus poor healing, we can actively open the infected sinus, use VSD technology to treat granulation wounds, then divert the implanted vascular prosthesis to prepare fresh local flap which covers the vascular prosthesis, and use new silver ion dressing to cover the wounds, thus achieving satisfactory results.