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Published on: December 3, 2017
Prosthetic infections
A Matarazzo1, O Sassi, A Florio
1Cattedra di Chirurgia Vascolare, Seconda Università degli Studi, Naples, Italy.
Background:
The authors report the up to date trends regarding the etiopathology, diagnosis and treatment of vascular-graft infections. This paper concerns the responsible micro-organisms; the reference to the formation of anastomotic pseudo-aneurysm for the infections involving the lines of suture and the reference to the aortoenteric fistula.
Methods:
A case study which refers to the period between 1990 and 1999 presents 19 cases of prosthetic infections out of 520 operations of implants of prosthetic materials.
Results:
11 successful, 7 amputations, 1 decrease.
Conclusions:
In the past years the results of the treatment have improved thanks to a more refined and codified therapeutical conduct and to the employment of prosthetic materials which are more resistant to infection, or to a greater attention paid to asepsis, before, during and after surgery to antibiotic prophylaxis before, during and after the operation. But, nevertheless graft infection still remains a dreadful complication for vascular surgery operations. The therapeutical approach is substantially aggressive and the removal of the infected prosthesis is essential. Nevertheless we believe that we should not underestimate open local treatment, which in localized and superficial infections and infections not involving anastomosis allows us to preserve prosthesis and make it root.
Insights
Vascular graft infections are serious complications, but treatment outcomes have improved with better materials and surgical care. Early, localized infections may allow for prosthesis preservation through open local treatment.
Area of Science:
- Vascular Surgery
- Infectious Diseases
- Prosthetic Materials
Background:
- Vascular graft infections pose significant challenges in surgical practice.
- Understanding etiopathology, diagnosis, and treatment is crucial.
- Key concerns include causative microorganisms, anastomotic pseudoaneurysm, and aortoenteric fistula.
Purpose of the Study:
- To review current trends in vascular-graft infection management.
- To analyze the outcomes of prosthetic infections.
Main Methods:
- A retrospective case study analyzing 19 prosthetic infections from 520 implant operations between 1990 and 1999.
Main Results:
- Out of 19 cases, 11 treatments were successful.
- Seven patients required amputation.
- One case resulted in a decrease in condition.
Conclusions:
- Treatment results have improved due to refined protocols, infection-resistant materials, and enhanced aseptic techniques.
- Graft infection remains a severe complication requiring aggressive treatment, often involving prosthesis removal.
- Open local treatment is a viable option for select, localized infections, potentially preserving the prosthesis.
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