As the number of patients who are older than 65 years of age continues to gow in the United States, we are beging to see fatigue of implantable devices that may need to be replaced, exchanged, or upgraded. As a person ages, so do the vessels in the body that supply blood and oxygen to the organs. Diseases of the blood vessels that causes narrowing or weakening of the vessel wall include is called perihperal vascular disease.
The prevalence of peripheral vascular disease in the general population is 12–14%, affecting up to 20% of those over 70. Peripheral vascular disease affects 1 in 3 diabetics over the age of 50.
In the USA peripheral arterial disease affects 12–20 percent of Americans age 65 and older. Approximately 10 million Americans have PVD. Surgical treatment of peripheral vascular disease includes stenting open arteries that are narrowed or often replacing segements of arteries with grafts. Ocassionally, these grafts can become infected or exposed and necessate the coordinated efforts of Plastic & Reonstructive Surgeons with Vascular Surgeons to maximize outcomes.
The sartorius muscle flap is a type IV muscle with a segmental blood supply. The muscle is often used in the setting of exposed, infected, or replaced bypass grafts to provided soft tissue coverage to close an anatomic "dead space' or help deliver antibiotics to the area.
The photo series below depicts a femoral limb of an aorto-bifemoral graft which has been covered with a sartorius flap to help deliver antibiotics to the region so that the graft deliver blood to perfused the leg.
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