Infected arterial grafts: clinical manifestations and surgical management

The clinical manifestations and results of management in twenty-five patients treated for infected vascular grafts are reviewed. The overall incidence of infection in this series of prosthetic grafts is 1.4%. Staphylococcus aureus was found to be the single most common infecting organism and multiple organisms were found in nine patients. Therapy was divided into three methods of management: local therapy alone resulted in a mortality of 45% and an amputation rate of 36.3%; partial graft excision resulted in a mortality of 20% and an amputation rate of 60%; total graft excision resulted in a mortality of 22% and an amputation rate of 22% as well. All amputations were above-knee amputations and the most common cause of death was continuing sepsis. The overall mortality of 32% and a loss of limb rate of 44% are testimony to the serious nature of this problem.