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Infections associated with vascular reconstruction procedures at the Department of Surgery in Pilsen in retrospect
Introduction:
Vascular graft infection is a rare but serious complication in vascular surgery, associated with high morbidity and mortality. Early diagnosis of vascular graft infection is important for proper and timely surgical and antibiotic treatment that improves the outcome. The tactic and techniques of surgical treatment of vascular graft infection have changed over the last two decades, and this trend can also be observed in our retrospective study.
Methods:
We evaluated a group of patients with prosthetic vascular reconstructions performed at the Department of Surgery, University Hospital in Pilsen in the period of 2003-2021 using retrospective analysis. In the analyzed 19-year period, 23 infected vascular grafts were managed out of a total of 2090 performed peripheral bypasses, and 27 infected vascular grafts were managed out of a total set of 1940 central reconstructions.
Results:
The incidence of peripheral vascular graft infections at our Department of Surgery in the period of 2003-2021 reached 1.1% with the early mortality rate of 8.7%; 1.4% central vascular graft infections occurred in the same time period with 33% early mortality.
Conclusion:
The results of our retrospective study are comparable virtually in all parameters with the experience of other departments. Consistently, our department switched to in situ replacements for explanted vascular grafts and we can confirm good experience with silver impregnated grafts.
Insights
Vascular graft infections are serious complications. This study found 1.1% peripheral and 1.4% central graft infection rates, with improved outcomes using in situ replacements and silver-impregnated grafts.
Area of Science:
- Vascular Surgery
- Infectious Diseases
Background:
- Vascular graft infection is a rare but severe complication impacting patient morbidity and mortality.
- Early diagnosis and treatment are crucial for improving outcomes in vascular graft infections.
- Surgical treatment strategies for vascular graft infections have evolved over the past two decades.
Purpose of the Study:
- To analyze the incidence and outcomes of vascular graft infections over a 19-year period.
- To evaluate changes in surgical tactics for managing infected vascular grafts.
- To assess the effectiveness of in situ replacements and silver-impregnated grafts.
Main Methods:
- Retrospective analysis of patients with prosthetic vascular reconstructions from 2003-2021.
- Evaluation of 23 infected peripheral vascular grafts out of 2090 bypasses.
- Assessment of 27 infected central vascular grafts out of 1940 reconstructions.
Main Results:
- Incidence of peripheral vascular graft infections was 1.1% with an 8.7% early mortality rate.
- Incidence of central vascular graft infections was 1.4% with a 33% early mortality rate.
- Study findings are comparable to other national and international experiences.
Conclusions:
- The department has adopted in situ replacements for explanted vascular grafts.
- Good outcomes have been observed with the use of silver-impregnated grafts.
- Management strategies for vascular graft infections continue to evolve, showing improved results.
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