An aggressive local approach to vascular graft infection
| Autor: | John D.S. Reid, Joseph G. Sladen, Jerry C. Chen |
|---|---|
| Rok vydání: | 1998 |
| Předmět: |
Male
Reoperation medicine.medical_specialty Prosthesis-Related Infections Time Factors medicine.drug_class medicine.medical_treatment Antibiotics Femoral vein Lower risk Staphylococcus epidermidis Blood vessel prosthesis Risk Factors medicine Humans Polytetrafluoroethylene Aged Debridement biology Vascular disease business.industry General Medicine Perioperative Femoral Vein biology.organism_classification medicine.disease Surgery Blood Vessel Prosthesis Female business Tomography X-Ray Computed |
| Zdroj: | American journal of surgery. 176(2) |
| ISSN: | 0002-9610 |
| Popis: | Purpose: To present the use of sartorius myoplasty (SM) and superficial femoral vein (SFV) in a graft-sparing approach to vascular graft infection. Methods: Twenty-five patients were treated for Szilagyi grade III groin infections during the last 10 years. Fifteen presented early (E), mean 2 months; 10 late (L), mean 6.5 years. Bacteria E/L: Staphylococcus epidermidis 1/7, S aureus 6/0, other Gram positive 1/0, Gram negative 4/1, mixed 6/0 (one pseudomonas). There were 13 aortofemoral (AF), 5 crossover, and 7 femoral distal reconstructions. SM was used to cover exposed grafts after radical debridement. When the graft was free-floating or bleeding, this segment was removed and replaced with SFV. The remaining infection was controlled with antibiotics. Results: One of 10 patients treated by SM alone required SFV replacement for bleeding. Four of 9 AFs treated by partial SFV replacement ± SM had persistent infection treated by complete graft removal in 3. Six grafts were removed electively in lower risk situations. There was no perioperative mortality, and no early or late limb loss. Conclusions: This experience supports an attempt at aggressive local treatment in frail patients. |
| Databáze: | OpenAIRE |
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