Staphylococcus aureus is the most common pathogen involved.
Complications of infection:
(1) abscess
(2) endarteritis requiring vascular reconstruction
(3) mycotic pseudoaneurysm
(4) bacteremia
(5) septic emboli
Presentation:
(1) fever
(2) groin pain
(3) erythema at site
(4) swelling
(5) drainage
(6) leukocytosis
Risk factors for infection:
(1) use of the Perclose device (which has a nonabsorbable suture that can reach the skin surface)
(2) any breakdown in sterile technique
(3) immunodeficiency, diabetes mellitus or other risk factors for infection
(4) puncture through a prosthetic vascular graft (Sohail et al)
Protective measures:
(1) administration of prophylactic antibiotics with antistaphylococcal coverage, if the patient is at risk for infection or the Perclose device is used (Tiesenhausen et al, Johanning et al) or if prosthetic vascular graft is entered for access (Sohail et al)
(2) aggressive debridement at first sign of infection, which may be delayed
