Antibiotic-loaded polymethylmethacrylate beads for the treatment of extracavitary vascular surgical site infections

Stone, Patrick A.; Mousa, Albeir Y.; Hass, Stephen M.; Dearing, Daniel; Campbell, James; Parker, Ashley Rapp; Thompson, Stephanie; AbuRahma, Ali F.

doi:10.1016/j.jvs.2011.12.037

Cited by 41 publications

(39 citation statements)

References 21 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…More recently, graft infection is predominately caused by S. aureus , particularly methicillin-resistant Staphylococcus aureus (MRSA), S. epidermidis , and E. coli , and even more frequently mixed infections including a variety of Gram negative bacteria. 1,12,13 Early infecting organisms such as S. aureus , E. coli , Proteus , and P. aeruginosa are typically more virulent, seen in extra-cavitary infections, and associated with higher rates of anastomotic disruption and worse outcomes. 1,6,13 As in recent studies, the pathogens in our series included multiple organisms, including MRSA, vancomycin-resistant Enterococci faecalis (VRE), P. aeruginosa , and E. coli .…”

Section: Discussionmentioning

confidence: 99%

Bio-absorbable antibiotic impregnated beads for the treatment of prosthetic vascular graft infections

et al. 2016

View full text Add to dashboard Cite

Objective There is limited investigation into the use of bio-absorbable antibiotic beads for the treatment of prosthetic vascular graft infections. Our goal was to investigate the rates of infection eradication, graft preservation, and limb salvage in patients who are not candidates for graft explant or extensive reconstruction. Methods A retrospective review of patients implanted with antibiotic impregnated bio-absorbable calcium sulfate beads at a major university center was conducted. Results Six patients with prosthetic graft infections were treated with bio-absorbable antibiotics beads from 2012–2014. Grafts included an aortobifemoral, an aorto-hepatic/superior mesenteric artery, and four extra-anatomic bypasses. Pathogens included Gram-positive and Gram-negative bacteria. Half of the patients underwent graft explant with reconstruction and half debridement of the original graft, all with antibiotic bead placement around the graft. Mean follow-up was 7.3±8.3 months; all patients had infection resolution, healed wounds, and 100% graft patency, limb salvage, and survival. Conclusion This report details the successful use of bio-absorbable antibiotic beads for the treatment prosthetic vascular graft infections in patients at high risk for graft explant or major vascular reconstruction. At early follow-up, we demonstrate successful infection suppression, graft preservation, and limb salvage with the use of these beads in a subset of vascular patients.

show abstract

Section: Discussionmentioning

confidence: 99%

Bio-absorbable antibiotic impregnated beads for the treatment of prosthetic vascular graft infections

et al. 2016

View full text Add to dashboard Cite

show abstract

“…Reported infection clearance rates range from 60% to 100% with recurrence rates between 0% and 20%. [15][16][17][18][19] Our previous study using antibiotic beads for left ventricular assist device (LVAD) salvage, where the infected LVAD device remained in the infected pocket by necessity, demonstrated pocket sterilization (>2 consecutive negative fluid cultures) in 65.4% of cases with a recurrence rate of 17.6%. 20 In this study where the breast prosthesis was exchanged, our pocket sterilization rate was 100%.…”

Section: Antibiotic-impregnated Pmma Implantsmentioning

confidence: 99%

One-Step Salvage of Infected Prosthetic Breast Reconstructions Using Antibiotic-Impregnated Polymethylmethacrylate Plates and Concurrent Tissue Expander Exchange

Albright

Xue

McKnight

et al. 2016

Annals of Plastic Surgery

View full text Add to dashboard Cite

show abstract

“…5 Antibiotic-impregnated beads have been successfully used in the treatment of prosthetic-related infections by orthopedic and vascular surgeons with reported clearance rates ranging from 60% to 100% with recurrence rates ranging from 0 to 20%. 22,[27][28][29][30][31] The beads are capable of delivering high concentrations of necessary antibiotics directly to a site of infection, thereby reducing the systemic side effects. Beads are available in resorbable and nonresorbable materials.…”

Section: Left Ventricular Assist Device Salvagementioning

confidence: 99%

Treatment of Infected Cardiac Implantable Electronic Devices

Fakhro

Jalalabadi

Brown

et al. 2016

Seminars in Plastic Surgery

View full text Add to dashboard Cite

Since their earliest application, cardiac implantable electronic devices (CIEDs), such as pacemakers, implantable defibrillators, and left ventricular assist devices (LVADs), have proven beneficial in the prevention of fatal cardiac-related disorders. 1 The past 50 years have seen a sharp rise in cardiac implantable device use with a resultant decline in deaths from ischemic, myocardial, and cardiac rhythm causes. 2 As the indications and guidelines governing CIED use broaden, so too does their widespread employment. 3 The rate of CIED infections has mirrored their increased use with some studies suggesting that the rate of device infections has overshadowed their implantation rate. 4 Infections pose a severe burden on patients, lead to significant health care costs and lengthy hospital stays, and may also lead to mortality. 5 When compared with noninfectious cardiac device complications, pacemaker infections result in an 8.4-to 11.6-fold increase in mortality rates along with a mean hospitalization cost ranging from $31,149 to $55,003. 6 Although both pacemakers and LVADs are implantable cardiac devices, their infection profile and treatment differ significantly due to the size of the device and the need for an external power source for the LVAD. However, both demonstrate a wide range of infection rates, with the true incidence of infection remaining elusive. 7 Topkara et al report a pacemaker infection rate of between 13% and 80%; however, others estimate it to be between 2% and 4% with rates rising 124% between years 1990 to 1999 and a 57% rise from 2004 to 2006, respectively. 8,9 Similarly, infection rates related to LVAD placement demonstrate a large range of between 13% and 80% among recipients. 10 This wide variability in infection risk is in part due to different types of infections that have been included under the category of CIED-related infections. Various reports broadly included patients with surgical site infections, postoperative pneumonia, central venous catheter-related sepsis, and nosocomial urinary tract infections, in addition to infection of the CIED. 10 Various comorbidities may contribute to CIED infections. Patients of advanced age, with congestive heart failure, with a metastatic malignancy, on corticosteroid therapy, or with renal failure are more likely to develop CIED infections thereby increasing their mortality. 9 Device Infection Diagnosis PacemakersThe diagnosis of pacemaker infections is often challenging. Pocket site infections are diagnosed clinically, often presenting with inflammatory skin changes including pain, swelling, AbstractWith their rising benefits, cardiac implantable electronic devices (CIEDs) such as pacemakers and left ventricular assist devices (LVADs) have witnessed a sharp rise in use over the past 50 years. As indications for use broaden, so too does their widespread employment with its attendant rise of CIED infections. Such large numbers of infections have inspired various algorithms mandating treatment. Early diagnosis of inciting organisms is crucial to...

show abstract

Antibiotic-loaded polymethylmethacrylate beads for the treatment of extracavitary vascular surgical site infections

Cited by 41 publications

References 21 publications

Bio-absorbable antibiotic impregnated beads for the treatment of prosthetic vascular graft infections

Bio-absorbable antibiotic impregnated beads for the treatment of prosthetic vascular graft infections

One-Step Salvage of Infected Prosthetic Breast Reconstructions Using Antibiotic-Impregnated Polymethylmethacrylate Plates and Concurrent Tissue Expander Exchange

Treatment of Infected Cardiac Implantable Electronic Devices

Contact Info

Product

Resources

About