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Updated: Aug 10, 2026
Surgical Technique for the Implantation of Tissue Engineered Vascular Grafts and Subsequent In Vivo Monitoring
Published on: April 3, 2015
Intraoperative bacterial contamination of vascular grafts: a prospective study
Abstract:
The establishment of graft infection depends on host response, an appropriate field and bacterial contamination. Intraoperative bacterial contamination of prosthetic graft material was studied prospectively in 77 patients. Vascular reconstruction was indicated for abdominal aortic aneurysm (15%), claudication (42%), rest pain (25%) and ulceration or gangrene (18%). In 78% of cases the procedure was elective. Staphylococcus epidermidis was isolated in 80% of cultures; mixed flora were more frequent in patients with rest pain (60%) and ulceration or gangrene (45%) than in those with aneurysms (22%) or claudication (16%). Grafts became contaminated in 56% of cases using standard techniques; this was lowered to 35% when the surgeon changed gloves before preclotting the graft. There was no significant difference with respect to the surgeon who performed the operation, the indication for operation, primary versus secondary repair or the use of skin barriers. One patient (1.3%) had an established graft infection. It is concluded that the incidence of contamination is high but may be decreased by glove changing.
Insights
Intraoperative bacterial contamination of vascular grafts is common. Changing gloves before pre-clotting significantly reduces graft contamination rates, lowering infection risk.
Area of Science:
- Vascular Surgery
- Infectious Disease
- Surgical Microbiology
Background:
- Graft infection is a serious complication in vascular surgery.
- Bacterial contamination during surgery is a key factor in graft infection.
- Understanding contamination sources is crucial for prevention.
Purpose of the Study:
- To prospectively assess intraoperative bacterial contamination rates of prosthetic vascular grafts.
- To identify factors influencing graft contamination.
- To evaluate the effectiveness of glove changing in reducing contamination.
Main Methods:
- Prospective study of 77 patients undergoing vascular reconstruction.
- Bacterial cultures taken from prosthetic graft material during surgery.
- Analysis of contamination rates based on surgical techniques and patient factors.
Main Results:
- Graft contamination occurred in 56% of cases with standard techniques.
- Contamination decreased to 35% when surgeons changed gloves before pre-clotting.
- Staphylococcus epidermidis was the most common isolate (80%).
- Mixed flora were more frequent in patients with critical limb ischemia indications.
Conclusions:
- Intraoperative bacterial contamination of vascular grafts is frequent.
- Changing surgical gloves before graft pre-clotting is an effective measure to reduce contamination.
- Minimizing contamination is essential for preventing graft infection.
