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Raymond Vetsch, MD; Dennis F. Bandyk, MD; David D. Schmitt, MD; Thomas M. Bergamini, MD; James D. Storey, MD; Jonathan B. Towne, MD

Arch Surg. 1989;124(4):425-428.

Abstract
• The tensile strength and histologic features of anastomotic bonding were studied prior to and following in situ replacement of aortic vascular prostheses infected by Staphylococcus epidermidis. Sterile (n=6) and infected (n=19) Dacron grafts were used to replace the abdominal aorta of 25 dogs. After five weeks, grafts were explanted, and peak tensile force (measured in kilograms) required for anastomotic disruption was measured using a linear gain tensiometer. Anastomotic tensile strength (mean±SEM) of infected grafts (5.4±0.5 kg) was decreased when compared with that of sterile, control grafts (9.0 ± 0.9 kg). The decreased anastomotic tensile strength of infected grafts was the result of an inflammatory aortitis adjacent to the suture line. Only grafts infected with the study strain of bacteria demonstrated signs of infection. In 19 dogs, the graft infection was treated by graft excision, antibiotic administration, and in situ graft replacement (Dacron or polytetrafluoroethylene prostheses). After five weeks and 12 weeks, anastomotic tensile strength of polytetrafluoroethylene (10.6±0.6 kg) and Dacron (10.8±0.5 kg) replacement grafts was similar to that of uninfected control grafts. In situ replacement of vascular prostheses infected by S epidermidis can result in graft healing with normal anastomotic bonding.

(Arch Surg 1989;124:425-428)

Author Affiliations
From the Surgical Service, Veterans Administration Medical Center, Milwaukee (Drs Vetsch, Bandyk, Storey, and Towne), and the Department of Surgery, The Medical College of Wisconsin, Milwaukee (Drs Bandyk, Schmitt, Bergamini, and Towne).

Footnotes
Accepted for publication Dec 2, 1988.

Read before the 12th Annual Surgical Symposium of the Association of Veterans Administration Surgeons, Minneapolis, May 13, 1988.

Reprint requests to Department of Surgery, MCMC, 8700 W Wisconsin Ave, Milwaukee, WI 53226 (Dr Bandyk).

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