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Delayed v Immediate Vascular Reconstruction

William D. Turnipseed, MD; Herbert A. Berkoff, MD; Don E. Detmer, MD; Charles W. Acher, MD; Folkert O. Belzer, MD

Arch Surg. 1983;118(4):410-414.

Abstract
• We evaluated the treatment and clinical outcome of 20 patients with major abdominal vascular graft infections and found that immediate reconstruction of arterial inflow to the lower extremities after complete removal of contaminated graft material may not always be necessary or advisable. Patients were treated by the following categories: group 1, graft removal with immediate vascular reconstruction (seven patients, two aortolliac and five aortofemoral grafts); group 2, graft removal with delayed vascular reconstruction (13 patients, three aortoiliac, five aortofemoral, and five extra-abdominal grafts). The mortality (57%) and the incidence of major amputation (14%) were highest when immediate vascular reconstruction was attempted. Patient survival, the incidence of recurrent graft infection, and the need for major amputation were favorably altered with delayed reconstruction even when prosthetic material was used.

(Arch Surg 1983;118:410-414)

Author Affiliations
From the Center for Health Sciences, University of Wisconsin Hospital and Clinics, Madison.

Footnotes
Accepted for publication Oct 15, 1982.

Read before the Sixth Annual Surgical Symposium of the Association of Veterans Administration Surgeons, Atlanta, May 14, 1982.

Reprint requests to University of Wisconsin Hospital and Clinics, 600 Highland Ave, Madison, WI 53792 (Dr Turnipseed).

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