Background
In vascular surgery, surgical site infection [SSI] is the most common postoperative morbidity, occurring in 5–10% of vascular patients. The optimal management of surgical site infection [SSI] with involved lower limb vascular grafts remains controversial. We present our 6-year results of using the V.A.C. system in [SSI] with involved vascular grafts.

Methods
A retrospective 6-years review of patient who underwent a VAC® therapy for postoperative surgical site infection [SSI] in lower limb with involved vascular grafts in our department between January 2006 and December 2011. V.A.C therapy was used in 40 patients [34 male, 6 female, median age 72.4]. All patients underwent surgical wound revision with VAC® therapy and antibiotics.

Results
The mean time of use of the V.A.C. system was 14.2 days [range 10 to 20] days. There was no evidence of infection after mean of 12 [range 10 to 20] days in 34 of 40, in whom the use of VAC® therapy resulted in delayed primary closure or healing by secondary intention.The mean postoperative follow-up time was 61.67 months [range 36-83 months], during which 3 [7.5%] patients died.

Conclusion
We showed that the V.A.C. System is valuable for managing severe complications in vascular surgery, specifically surgical site infection [SSI] with involved vascular grafts. Using the V.A.C. System, reoperation rates are reduced; 85% of patients avoided graft replacement.