We recommend the use of the Alexis® wound protector/retractor (Applied Medical, Rancho Santa Margarita, CA, US) for the medial approach to the infrageniculate arteries (Fig 1). It provides the required wound retraction and avoids the need for suture snagging self-retaining retractors as well as cumbersome ‘large damp swabs’. Use of a wound protector/retractor may provide additional benefits such as a reduced rate of surgical site infection, reduced incision size and less pain.
Figure 1.
In the figure shown, no vascular clamps were needed but they can easily be applied when required either through the plastic membrane or underneath the Alexis®.