Case study: chronic femoropopliteal prosthetic graft infection with exposed graft
| Autor: | H. Reid Mattison, M. Ann Bryant, Janet L. Divelbiss, Matthew F. Wack, Robert A. McCready |
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| Rok vydání: | 2009 |
| Předmět: |
Reoperation
medicine.medical_specialty Prosthesis-Related Infections medicine.medical_treatment Revascularization Surgical Flaps Sepsis Blood Vessel Prosthesis Implantation medicine Humans Transplantation Homologous Popliteal Artery Proteus mirabilis Device Removal Aged Peripheral Vascular Diseases Wound Healing Groin business.industry Incidence (epidemiology) Mortality rate General Medicine medicine.disease Surgery Anti-Bacterial Agents Blood Vessel Prosthesis Transplantation Femoral Artery medicine.anatomical_structure Treatment Outcome Amputation Concomitant Chronic Disease Female Cardiology and Cardiovascular Medicine business Tomography X-Ray Computed |
| Zdroj: | Vascular and endovascular surgery. 43(3) |
| ISSN: | 1538-5744 |
| Popis: | One of the most feared complications following vascular reconstruction is infection due to the attendant risks of limb loss, sepsis, or death. The reported incidence of infection following infrainguinal prosthetic graft infection is 2.5% with associated mortality rates and amputation rates of 18% and 41%, respectively. There are several options in treating infected prosthetic infrainguinal bypass grafts. Some authors have advocated complete removal of the infected graft with concomitant in situ revascularization using autogenous tissue or extra-anatomic bypass using either autogenous or prosthetic material, depending upon the clinical circumstances. Other authors have advocated attempting graft preservation to decrease the risk of amputation. Infected, thrombosed grafts are generally treated with graft excision alone with care taken to preserve collateral flow. The treatment options may also be influenced by the type of infection, as infections caused by gram-negative bacteria are thought to be more virulent than those associated with gram-positive bacteria. We recently treated a patient with an 18-month history of an exposed prosthetic graft in the groin, which was infected by Proteus mirabilis. Despite the extended period of graft exposure and despite gram-negative bacteria being the causative organism, the patient reported only intermittent drainage of pus from the groin. The management of this unusual infection forms the basis of this report. |
| Databáze: | OpenAIRE |
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