Exposure of femoral vessels through transverse inguinal crease versus vertical incision

Abstract

Background: Traditional vertical wound in the femoral triangle carries high risk of more lymphatic affection and complication. So, alternative transverse inguinal crease incision (TICI) is used to avoid such complications.
Aim: to compare the transverse inguinal crease incision with the traditional vertical one (VII) during exposure of femoral vessels for any vascular purpose.
Patients and methods: a comparative study was done. 80 groin incisions (40 for transverse and 40 for vertical incisions for femoral vessel exposure) in SAYED GALAL and ALHUSSIEN University Hospitals from January 2019 to January 2021.
Results: Wound infection rate was 12.6% in VII group compared to 6.3% in TICI group. 13% seroma were observed in VII group; while in TICI group, only 6 (7.5%) seroma were observed. Nine hematomas were observed in VII group (11%) compared to 7.5% in TICI group. Graft occlusion was 7.5% in VII which was higher than TICI that was 5% (4 cases). 7.5% suffered from paresthesia in VII group compared to no case of paresthesia in TICI group. The duration of postoperative stay after VII surgery was relatively longer than that following TICI group which were 14 day compared to 9 days respectively.
Conclusion: The TICI is a good maneuver for exposure of the femoral vessels used for all supra- and infra-inguinal procedures except when the wound extension is expected. TICI has decreased complications rate and shortened hospital stay compared to VII.