Infected Prosthetic Grafts

Popovsky, Julio; Singer, Sanford S.

doi:10.1001/archsurg.1980.01380020069016

Cited by 35 publications

(1 citation statement)

References 10 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…The organisms were all enteric. Similar success in localized infection in groin wounds has recently been reported by Popovsky.3 3 Sterile perigraft fluid collection have only recently received attention in literature In many instances, especially in groin wounds, these are felt to represent lymph fistulae. Early wound exploration, debridement and closure has been demonstrated to successfully seal these wounds and result in graft healing.…”

Section: Discussionmentioning

confidence: 58%

Management of Draining Wounds in Vascular Surgery

et al. 1982

View full text Add to dashboard Cite

Drainage from a wound overlying a prosthetic vascular graft is a source of major concern in vascular surgery, often heralding serious complications including hemorrhage, thrombosis or infection. Despite improvement in graft design and surgical technique, healing problems are reported to occur in about 2 % of cases. 1 Perigraft fluid collections may be secondary to infection, accumulation of lymph or serum, to failure of the graft material or to allergy to graft material or some foreign substance adherent to its surface. 1-6The management of draining wounds remains controversial. Early experience with infected grafts treated locally was uniformly unsuccessful, and resulted in significant morbidity and mortality. 1 This led to the classic teaching that grafts underlying infected wounds must be removed and replaced through extra anatomic pathways. Recently local treatment has received renewed interest in an attempt to salvage an otherwise functioning graft. 2,3 We have utilized an early aggressive local approach to draining wounds with salvage of grafts that would otherwise have been removed and a considerable decrease in morbidity. Materials and MethodsThe records of all patients undergoing arterial bypass procedures with prosthetic grafts in the past five years were reviewed. Seven patients with eight wound healing problems were encountered for an incidence of 2.3%. The patients were all male ranging from forty-four to eighty-three years of age. The indication for surgery was threatened limb loss in all cases. There were four axillo-femoral grafts, all of which were knitted double velour, and three aortofemoral grafts, two of which were knitted Dacron and one woven. Two patients

show abstract

Section: Discussionmentioning

confidence: 58%

Management of Draining Wounds in Vascular Surgery

et al. 1982

View full text Add to dashboard Cite

show abstract

Local antiseptic treatment of infected prosthetic vascular grafts in the groin

Moran

Jewell

1988

Journal of British Surgery

View full text Add to dashboard Cite

Groin wound infection after arterial surgery

Newington

Houghton

Baird

et al. 1991

Journal of British Surgery

View full text Add to dashboard Cite

Fifty-six patients, 30 with superficial and 19 with deep groin wound infections, and seven with lymph fistulae with positive cultures within 30 days of arterial surgery, were identified after 661 operations (873 groins at risk) between September 1984 and August 1988. The commonest infecting organisms were Staphylococcus aureus, Pseudomonas aeruginosa and Proteus spp. In 33 patients the infection settled completely after treatment with culture specific antibiotics. These were given intravenously then orally for up to 6 weeks. Sixteen patients required debridement and excision of necrotic wound edges, including one who had an antibiotic infusion into the wound. Graft excision was performed in seven patients of whom five received an extra anatomic bypass. The need for graft excision was much greater (six versus one) for Dacron and/or polytetrafluoroethylene than for vein. In two lymph fistulae sartorius transposition and wound resuture were used. All groins healed, though three extremities were ischaemic following occlusion of the bypass. There were two deaths, one from myocardial infarction and one from pulmonary embolism and no major amputations. These results suggest that most infective groin problems may be successfully managed conservatively and that radical graft excision is only necessary for a few intractable cases.

show abstract

Infected Prosthetic Grafts

Cited by 35 publications

References 10 publications

Management of Draining Wounds in Vascular Surgery

Management of Draining Wounds in Vascular Surgery

Local antiseptic treatment of infected prosthetic vascular grafts in the groin

Groin wound infection after arterial surgery

Contact Info

Product

Resources

About