Prosthetic graft infections: a review of 720 arterial prosthetic reconstructions

Six-hundred-and-three patients who underwent 720 vascular prosthetic graft operations caudal to the diaphragm were studied retrospectively. Wound complications appeared in 99 patients. Prophylactic antibiotics were not used. Serous secretion was found after 27 arterial graft procedures (3.8%), superficial wound infection after 41 (5.7%), and prosthetic graft infection after 31 (4.3%). Of the 31 patients with prosthetic graft infection, 10 recovered (32%). Four of these patients recovered after removal of the Staphylococcus aureus-infected prosthesis. Three received a replacement prosthesis with systemic antibiotic treatment and closed antibiotic irrigation, and one patient's prosthesis was replaced with an autologous vein graft with antibiotic treatment. Twelve patients (39%) underwent amputation and 9 died. The frequency of graft occlusion was greater when the prosthesis was infected with Staphylococcus aureus than with other microorganisms. The aggressive approach used in the 4 above-mentioned cases could be a treatment modality in prosthetic graft infection with Staphylococcus aureus, especially because of the high incidence of graft occlusion associated with these microorganisms.