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[Surgical management of patients with infected vascular prostheses]
Abstract:
We evaluated the therapeutic efficacy of surgical management of patients with infected vascular prostheses. Eight cases of infected vascular prosthetic grafts from 250 prosthetic bypasses were reviewed. The rate of graft infection was 3.2%. Clinical manifestations were localized wound infection with prosthetic graft exposure, anastomotic hemorrhage and gangrene in lower extremity. Treatment included graft removal and debridement; graft removal and primary amputation; graft removal and revascularization; debridement and local graft irrigation. Two cases died from anastomotic hemorrhage and the others recovered. The predisposing factors of vascular prosthetic infection are diabetes mellitus, secondary hemotoma and reoperation in the same position. Conservative treatment efforts without revascularization justifies a more aggressive approach to suspected graft infection.
Insights
Surgical management of infected vascular prostheses, including graft removal, is effective. Aggressive treatment is recommended for suspected graft infections, especially when conservative methods fail.
Area of Science:
- Vascular Surgery
- Infectious Diseases
- Surgical Outcomes
Context:
- Infected vascular prostheses pose significant challenges in surgical practice.
- Graft infection rates can impact patient morbidity and mortality.
- Understanding predisposing factors is crucial for prevention and early detection.
Purpose:
- To evaluate the therapeutic efficacy of surgical interventions for infected vascular prostheses.
- To analyze clinical manifestations and treatment outcomes in patients with prosthetic graft infections.
- To identify predisposing factors associated with vascular prosthetic infections.
Summary:
- A review of eight cases of infected vascular prosthetic grafts (3.2% infection rate) revealed diverse clinical presentations including wound infection, hemorrhage, and gangrene.
- Surgical treatments ranged from graft removal with debridement to amputation and revascularization.
- Predisposing factors identified include diabetes mellitus, hematoma, and reoperation.
Impact:
- Aggressive surgical management, including graft removal, is often necessary for favorable outcomes.
- Early and decisive intervention can improve patient survival and limb salvage rates.
- This study underscores the importance of considering aggressive surgical approaches for suspected graft infections, particularly when conservative measures are insufficient.