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Local infections after above-knee prosthetic femoropopliteal bypass for intermittent claudication

Gustav Pedersen1, Elin Laxdal, Malgorzata Hagala

  • 1Department of Surgery, Haukeland University Hospital, Bergen, Norway. gustav.pedersen@helse-bergen.no

Surgical Infections
|September 9, 2004
PubMed

Insights

Prosthetic graft infections after treating intermittent claudication are common. A selective, individualized approach to managing infected femoropopliteal prostheses, considering clinical presentation and bacteria, is recommended.

Area of Science:

  • Vascular Surgery
  • Infectious Disease Management

Background:

  • Prosthetic graft use for intermittent claudication remains controversial.
  • Graft infection is a serious complication of prosthetic bypass surgery.
  • Managing prosthetic graft infections presents significant challenges.

Purpose of the Study:

  • To analyze lymphatic and local infection complications after prosthetic bypass for intermittent claudication.
  • To identify risk factors associated with graft infections.
  • To evaluate treatment outcomes for infected grafts.

Main Methods:

  • Retrospective study of 141 consecutive operations on 129 patients (1990-2001).
  • Analysis of lymphatic complications, surgical site infections, and graft infections.
  • Correlation of complications with preoperative risk factors, secondary procedures, and outcomes.

Main Results:

  • High rates of lymph complications (18/141), surgical site infections (11/141), and graft infections (17/141) observed.
  • 11 of 17 infected grafts were successfully treated without excision, with 6 healing with antibiotics alone.
  • Postoperative lymph fistula significantly correlated with local infection risk; reoperative surgery increased graft infection risk.

Conclusions:

  • The study highlights a high frequency of graft infections in femoropopliteal prostheses.
  • A selective, individualized approach to managing infected prostheses is suggested.
  • Conservative management strategies for surgical treatment of intermittent claudication are advocated.
Abstract

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