The lack of formal radiation safety training in respondents may reflect an inadequate state of radiation safety education and practices among U.S. vascular surgery residents.

Introduction: We evaluated outcomes of closed incisional negative pressure therapy (ciNPT) on surgical site infection (SSI) rates in lower extremity bypass patients. We sought to determine whether or not the routine use of ciNPT is a cost-effective measure. Methods: During a period from May 2018 to August 2018, our institution transitioned to the routine use of ciNPT for re-vascularization procedures. We retrospectively reviewed our outcomes before and after the initiation of ciNPT. Group A included patients from September 2017 to April 2018 without ciNPT and Group B included patients from September 2018 to April 2019 with ciNPT. Chi-squared analysis was performed and the p value was set at <0.05 to obtain statistical significance. Cost analysis was separately performed utilizing hospital metrics. Results: There were a total of 102 patients in Group A and 113 patients in Group B. There was no difference in demographic information between the two groups. The overall SSI rate for Group A was 11.8% (12/102). Group B had an overall SSI rate of 3.5% (4/113; p=0.02). Deep infection rate for Group A was 7% (7/102) and for Group B was 1% (1/113; p=0.01). Cost analysis demonstrated a minimum of $62,000 in infection-related cost savings between both groups. Conclusions: ciNPT has had a profound effect on our practice and has resulted in a decrease in both deep and superficial infections. This has led to a significant cost-effective measure for our institution. We now routinely use ciNPT on all lower extremity bypass patients.

These patients may be expected to have more complex operations, followed by increased rates of perioperative adverse events. In addition, despite equivalent graft patency rates, patients undergoing LEB for ALI have significantly higher rates of amputation and mortality at 1 year.

Our studies suggest that IL-1b inhibits outward remodeling in the aorta. While IL-1b is a pro-inflammatory cytokine, its effects on macrophage polarization differ from TNF-a. The differential effects of TNF-a and IL-1b inhibition on M1 macrophage polarization may account for the differences in clinical efficacy of TNF-a and IL-1b antibody therapies in management of inflammatory diseases.