This study compared the outcomes of groins with complex vascular graft infections that were reconstructed using the sartorius turnover flap versus no flap. A retrospective review of 100 consecutive patients with severe vascular graft infections was performed; the groins in 50 were reconstructed with sartorius flaps, whereas the remaining 50 were closed in layers. The primary end points were limb-loss and death. Secondary end points were recurrence of infection and re-operation. Kaplan-Meier analyses were performed for time to endpoint comparisons. 57 groins underwent sartorius reconstruction, and 51 were closed in layers. There were no statistical differences between sartorius reconstructions and controls in overall limb loss at 5 years (91% vs. 92%, p=0.997) or in mortality at one year (90% vs. 95%, p=0.484). There was a significantly lower time to re-operation in the sartorius flap group (9.0y, 95% confidence interval {6.1y-11.9y} vs. 1.7y {1.0y-2.4y}, p<0.001. A longer time to re-infection was observed in the sartorius group (8.6y {7.9y-9.3y} vs. 4.3y, {3.2y-5.5y}. This study demonstrates that the sartorius turnover flap improves the time to re-operation and reduces recurrent infection; it is an effective option for reconstruction of the groin after complex graft infections.