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Risk Factors for Groin Wound Infection After Femoral Artery Catheterization A Case-Control Study

Published online by Cambridge University Press:  21 June 2016

Philip M. Polgreen ,
Daniel J. Diekema ,
Jeff VandeBerg ,
R. Todd Wiblin ,
Yi Yi Chen ,
Sherry David ,
Dianne Rasmus ,
Nicole Gerdts ,
Angelena Ross  and
Louis Katz
...Show all authors
Philip M. Polgreen*
Affiliation:
Department of Internal Medicine, The University of Iowa Carver College of Medicine, Iowa City, Iowa
Daniel J. Diekema
Affiliation:
Department of Internal Medicine, The University of Iowa Carver College of Medicine, Iowa City, Iowa Department of Pathology, The University of Iowa Carver College of Medicine, Iowa City, Iowa Program of Hospital Epidemiology, University of Iowa Hospitals and Clinics, Iowa City, Iowa
Jeff VandeBerg
Affiliation:
Program of Hospital Epidemiology, University of Iowa Hospitals and Clinics, Iowa City, Iowa
R. Todd Wiblin
Affiliation:
Department of Internal Medicine, The University of Iowa Carver College of Medicine, Iowa City, Iowa Program of Hospital Epidemiology, University of Iowa Hospitals and Clinics, Iowa City, Iowa
Yi Yi Chen
Affiliation:
Program of Hospital Epidemiology, University of Iowa Hospitals and Clinics, Iowa City, Iowa
Sherry David
Affiliation:
Program of Hospital Epidemiology, University of Iowa Hospitals and Clinics, Iowa City, Iowa
Dianne Rasmus
Affiliation:
Genesis Medical Center, Davenport, Iowa
Nicole Gerdts
Affiliation:
Genesis Medical Center, Davenport, Iowa
Angelena Ross
Affiliation:
Genesis Medical Center, Davenport, Iowa
Louis Katz
Affiliation:
Genesis Medical Center, Davenport, Iowa
Loreen A. Herwaldt
Affiliation:
Department of Internal Medicine, The University of Iowa Carver College of Medicine, Iowa City, Iowa Program of Hospital Epidemiology, University of Iowa Hospitals and Clinics, Iowa City, Iowa
*
SW 54 GH, Department of Internal Medicine, University of Iowa Carver College of Medicine, 200 Hawkins Drive, Iowa City, IA 52242 ([email protected])
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Abstract

Objective.

Groin wound infection (GWI) after femoral artery catheterization is unusual. However, several reports of GWI associated with the use of a Perclose device appear in the surgical literature.

Design.

A case-control study.

Setting.

We pooled 23 cases and 83 controls from a university hospital and a community medical center.

Patients.

A case was defined as a patient who developed a GWI after a femoral artery catheterization. At the university hospital, 3 controls were randomly selected from the at-risk population and matched to each case by time of procedure only (within 2 weeks). At the community medical center, 4 controls were selected and matched to each case by time of procedure (within 2 weeks), sex, and age (within 5 years).

Results.

We considered several covariates, including age, sex, body mass index, medical conditions, Perclose use, hematoma formation, and antithrombotic therapy. In a multivariate model, only hematoma formation (odds ratio, 68.8; 95% confidence interval, 12.1-391.4) and glycoprotein IIb/IIIa platelet inhibitor therapy (odds ratio, 6.1; 95% confidence interval, 1.1-33.6) were statistically significant predictors of GWI; Perclose use (odds ratio, 0.9; 95% confidence interval, 0.2-3.7) was not a statistically significant predictor of GWI. However, most of the hematomas (15/17) formed after procedures during which a Perclose device was used.

Conclusion.

Perclose use did not have any additional effect on GWI risk beyond the effect that hematoma formation had.

Type
Original Articles
Information
Infection Control & Hospital Epidemiology , Volume 27 , Issue 1 , January 2006 , pp. 34 - 37
Copyright
Copyright © The Society for Healthcare Epidemiology of America 2006

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References

1.Weinstein, RA. Nosocomial infection update. Emerg Infect Dis 1998; 4: 416–420.Google Scholar
2.Elek, SD, Conen, PE. The virulence of Staphylococcus pyogenes for man: a study of the problems of wound infection. Br J Exp Pathol 1957; 38: 573–586.Google Scholar
3.Wyman, RM, Safian, RD, Portway, V, et al. Current complications of diagnostic and therapeutic cardiac catheterization. J Am Coll Cardiol 1988; 12:1400.Google Scholar
4.Franzee, BW, Flaherty, JP. Septic endarteritis of the femoral artery following angioplasty. Rev Infect Dis 1991; 13:620–623.Google Scholar
5.Boston, US, Panneton, JM, Hofer, JM, et al. Infectious and ischemic complications from percutaneous closure devices used after vascular access. Ann Vase Surg 2003; 17:66–71.Google Scholar
6.Hollis, HW, Rehring, TF. Femoral endarteritis associated with percutaneous suture closure: new technology, challenging complications. J Vase Surg 2003; 38:83–87.CrossRefGoogle Scholar
7.Johanning, JM, Franklin, DP, Elmore, JR, Han, DC. Femoral artery infections associated with percutaneous arterial closure devices. J Vasc Surg 2001; 34:983–985.Google Scholar
8.Pipkin, W, Brophy, C, Nesbit, R, Monday, JS. Early experience with infectious complications of percutaneous femoral artery closure devices. J Vasc Surg 2000; 32:205–208.Google Scholar
9.Smith, TP, Cruz, CP, Moursi, MM, et al. Infectious complications resulting from use of hemostatic puncture closure devices. Am J Surg 2001; 182: 658–662.Google Scholar
10.Sprouse, LR, Botta, DM, Hamilton, IN. The management of peripheral vascular complications associated with the use of percutaneous suture–mediated closure devices. J Vasc Surg 2001; 33:688–693.Google Scholar
11.Chamberlin, JR, Lardi, AB, McKeever, LS, et al. Use of vascular sealing devices (VasoSeal and Perclose) versus assisted manual compression (Femostop) in transcatheter coronary interventions requiring abciximab (ReoPro). Catheter Cardiovasc Interv 1999; 47:143–147.Google Scholar
12.Cura, FA, Kapadia, SR, L'Allier, PL, et al. Safety of femoral closure devices after percutaneous coronary interventions in the era of glycoprotein IIb/IIIa platelet blockade. Am J Cardiol 2000; 86:780–782.Google Scholar
13.Kahn, ZM, Kumar, M, Hallander, G, Frankel, R. Safety and efficacy of the Perclose suture–mediated closure device after diagnostic and interventional catheterizations in a large consecutive population. Catheter Cardiovasc Interv 2002; 55:8–13.Google Scholar
14.Vaitkus, PT. A meta-analysis of percutaneous vascular closure devices after diagnostic catheterization and percutaneous coronary intervention. J Invasive Cardiol 2004; 16:243–246.Google Scholar
15.Merritt, K, Hitchins, VM, Neale, AR. Tissue colonization from implantable biomaterials with low numbers of bacteria. J Biomed Mater Res 1999; 44:261–265.Google Scholar