 |
|
Infected Prosthetic Grafts
Robert E. Casali, MD;
William E. Tucker, MD;
Bernard W. Thompson, MD;
Raymond C. Read, MD, PhD
Arch Surg. 1980;115(5):577-580.
Abstract
| |
• An experience with 20 infected prosthetic grafts in a series of 652 prosthetic arterial reconstructions has been reviewed. There was 13 aortofemoral, one straight aortic, three femoropopliteal, one carotid subclavian, one axilloaxillary, and an axillocarotid graft. The most common site of infection was the groin. All patients had received preoperative and postoperative broad-spectrum antibiotic coverage, perhaps contributing to a high incidence of Gram-negative bacterial cultures. Early procrastination contributed to morbidity and mortality. Attempts at local wound management with drainage and irrigation generally failed, especially if the suture line was involved. Graft excision without revascularization resulted in a number of amputations and a high mortality. Excision of the entire aortofemoral graft combined with extra-anatomical revascularization was uniformly fatal. Our experience suggests that the first objective should be to establish operatively the extent of the infection. If very localized, antibiotic irrigation may cure. Involvement on one side can be treated in one stage by extra-anatomical bypass using the obturator foramen coupled with excision of the infected portion. If the entire graft is involved, we recommend extra-anatomical bypass as the initial procedure. High-dose antibiotic for systemic effect are then administered and two to three days later the infected graft is removed.
(Arch Surg 115:577-580, 1980)
Author Affiliations
From the Department of Surgery, Veterans Administration Medical Center, University of Arkansas for Medical Sciences, Little Rock, Ark.
Footnotes
Accepted for publication Sept 14, 1979.
Read before the third annual Veterans Administration Symposium Continuing Education in Surgery, Salt Lake City, May 7, 1979.
Reprint requests to Surgery Office, University of Arkansas Medical Center, 4301 W Markham, Little Rock, AR 72201 (Dr Casali).
 CiteULike  Connotea  Del.icio.us  Digg  Reddit  Technorati  Twitter
What's this?
THIS ARTICLE HAS BEEN CITED BY OTHER ARTICLES
|
Replacement of Infected Aortic Prostheses with Lower Extremity Deep Veins
Kakish and Clagett
PERSPECT VASC SURG ENDOVASC THER 1998;9:21-39.
ABSTRACT
A New Option for Treatment of Infected Aortic Prostheses: The NAIS Operation
Clagett
PERSPECT VASC SURG ENDOVASC THER 1993;6:91-110.
Axillary-Popliteal Artery Bypass Provides Successful Limb Salvage After Removal of Infected Aortofemoral Grafts
McCarthy et al.
Arch Surg 1992;127:974-978.
ABSTRACT
Bacteremic Infectability of Vascular Grafts: An Experimental Study
Cavallaro et al.
VASC ENDOVASCULAR SURG 1991;25:89-99.
ABSTRACT
Aortic Graft-Enteric Erosion Diagnosed by Contrast Sinography: Case Report and Review
Harding and Kirt Nichols
VASC ENDOVASCULAR SURG 1990;24:448-452.
ABSTRACT
Conservative Treatment of Polytetrafluoroethylene Grafts Infection
Joffe and Mordechay
VASC ENDOVASCULAR SURG 1989;23:464-469.
ABSTRACT
Surgical Treatment of Infected Aortofemoral Grafts: A Fifteen-Year Experience
di Marzo et al.
VASC ENDOVASCULAR SURG 1987;21:229-236.
ABSTRACT
Abdominal Aneurysmectomy Following Previous Peritonitis
Casali and Read
Arch Surg 1982;117:1235-1236.
ABSTRACT
Management of Draining Wounds in Vascular Surgery
Schaberg et al.
VASC ENDOVASCULAR SURG 1982;16:213-218.
ABSTRACT
Progress in the Management of Peripheral Vascular Disease
Blau and Kerstein
VASC ENDOVASCULAR SURG 1982;16:172-184.
ABSTRACT
Aortoiliac-Graft Infection: Detection by Leukocyte Scan
Stevick and Fawcett
Arch Surg 1981;116:939-942.
ABSTRACT
|
