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October 1980

Improved Femoral Incision for Arterial Bypass

Arch Surg. 1980;115(10):1242. doi:10.1001/archsurg.1980.01380100084021

To the Editor.—Evidence accumulated from many sources indicates that femoral incisions become infected more often than other incisions used in vascular operations. A majority of infections are due to Staphylococcus sp, which suggests that they originate as skin contaminants. Furthermore, detailed investigation suggests that certain parts of the body with skin folds, such as axilla and groin, are difficult to sterilize by commonly used preoperative preparations.1 For this reason, we modified our approach to the femoral area.

After washing and preparation with aqueous povidone-iodine, the operative field is covered with plastic adhesive drapes to isolate the groin folds. The skin incision is made about 2.5 to 5.0 cm lateral to the femoral artery to avoid the groin fold. The position of the incision varies somewhat, being more lateral in stout patients, always circumventing normally moist areas. In the Figure, the incision is represented by the dotted line and