Infections and antibiotic prophylaxis in reconstructive vascular surgery

Area of Science:

• Surgical Infectious Diseases
• Vascular Surgery
• Antimicrobial Prophylaxis

Background:

• Vascular graft infections pose a significant risk following surgery.
• Identifying infection sources and optimizing prophylactic strategies are crucial.
• Cefuroxime is commonly used for surgical antibiotic prophylaxis.

Purpose of the Study:

• To investigate the source of wound and graft infections in vascular surgery patients.
• To evaluate the effectiveness of cefuroxime prophylaxis in preventing these infections.
• To identify risk factors associated with increased infection rates.

Main Methods:

• Bacterial cultures obtained from urine, ulcers, wounds, and grafts in 98 patients.
• Comparison of culture results with infection occurrences and risk factors.
• Analysis of cefuroxime prophylaxis (24h) and supplemental 'spread prophylaxis' for ulcers.

Main Results:

• Three graft infections and twelve wound infections occurred.
• No significant correlation between pre/peroperative cultures and wound infections.
• Cefuroxime-sensitive bacteria found in one graft infection; resistant in another. Risk factors like ulcers or diabetes did not significantly increase infection frequency.

Conclusions:

• Cefuroxime appears adequate for vascular graft infection prophylaxis.
• A 24-hour cefuroxime regimen might be insufficient for patients with bacteriuria or catheters.
• The source of infection in two out of three graft infections remained undetermined.