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Infection of vascular prostheses
J P Fletcher1, M Dryden, T C Sorrell
1Department of Surgery, Westmead Hospital, New South Wales, Australia.
The Australian and New Zealand Journal of Surgery
|June 1, 1991
Summary
Vascular graft infections occurred in 3.4% of patients, with MRSA being the most common cause, particularly in groin reoperations. Prophylactic antibiotics targeting MRSA are recommended for these procedures.
Area of Science:
- Vascular Surgery
- Infectious Diseases
- Medical Device Infections
Background:
- Peripheral vascular disease often necessitates vascular prosthesis implantation.
- Graft infections pose a significant complication following vascular surgery.
- Identifying common pathogens and risk factors is crucial for prevention.
Purpose of the Study:
- To determine the incidence and characteristics of vascular prosthesis graft infections.
- To identify the most common microorganisms responsible for graft infections.
- To assess risk factors, particularly those related to revisional surgery and infection site.
Main Methods:
- Retrospective analysis of 322 patients undergoing vascular prosthesis insertion for peripheral vascular disease over a 4-year period.
- Documentation of graft infection occurrence, site, and causative organisms.
- Correlation of infections with previous procedures and incision sites.
Main Results:
- Graft infection rate was 3.4% (11 out of 322 patients).
- The groin was the most frequent site of infection.
- Multiple resistant Staphylococcus aureus (MRSA) was the predominant pathogen, implicated in 7 infections.
- Six of the 7 MRSA infections occurred in patients with prior graft procedures or groin incisions.
Conclusions:
- Graft infections are a notable complication in peripheral vascular disease surgery.
- MRSA is a primary concern, especially in revisional groin procedures.
- Prophylactic antibiotic strategies should consider MRSA coverage for patients undergoing repeat procedures, particularly involving the groin.