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Hemoaccess site infection.

F T Padberg1, B C Lee, G R Curl

  • 1Department of Veterans Affairs Medical Center, East Orange, New Jersey 07019.

Surgery, Gynecology & Obstetrics
|February 11, 1992
PubMed
Summary
This summary is machine-generated.

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Infectious complications from hemodialysis grafts are common, particularly with polytetrafluoroethylene (PTFE) grafts. Staphylococcus aureus was the main pathogen, and while partial graft removal often sufficed, complete removal or ligation was sometimes necessary.

Area of Science:

  • Nephrology
  • Infectious Diseases
  • Vascular Surgery

Background:

  • Infectious complications are a major cause of morbidity in patients undergoing chronic hemodialysis.
  • Access to the bloodstream via grafts or fistulas is essential for hemodialysis but carries infection risks.

Purpose of the Study:

  • To determine the incidence and causative organisms of infections in hemodialysis access procedures.
  • To evaluate the surgical management and outcomes of infected hemodialysis grafts and fistulas.

Main Methods:

  • A retrospective review of 274 consecutive hemodialysis access procedures.
  • Analysis of infection rates, types of access, predominant microorganisms, and surgical interventions.

Main Results:

Related Experiment Videos

  • An overall infection incidence of 10% was observed in 274 procedures, with 28 infections identified.
  • Polytetrafluoroethylene (PTFE) grafts had a higher infection rate (27/28 infections) compared to autogenous fistulas (1/48 infections).
  • Staphylococcus aureus was the most common pathogen; 14 of 27 PTFE graft infections were resolved by partial excision, while 13 required complete removal.

    • Conclusions:

    • Infectious complications are significantly more frequent in PTFE grafts than in autogenous fistulas used for hemodialysis access.
    • Surgical management of infected grafts, including partial or complete removal and arterial reconstruction, is generally well-tolerated.
    • Prompt surgical intervention is crucial for managing hemodialysis access infections to minimize morbidity.