PROSTHETIC GRAFT INFECTIONS

Purpose: Sythetic prosthetic graft implantation occupies an extended usage in the current vascular surgery. Although beneficial effects of increased usage of vascular prosthetic grafts in limb salvage and even remains a life-saving procedure have been proven, prosthetic graft infections become a real problem in the current vascular surgery interventions which leads to progress new treatment modalities such as different surgical approach and antibiotics with broad spectrums.

Methods: A retrospective analysis was performed on consecutive 39 patients, out of 1078 patients (3.61%), (mean age 60, range between 34-77 years) with prosthetic graft infection who underwent vascular surgery from 1998 to 2004. The symptoms of the patients at admittance were the prolongation of pain, fever, drainage from wound site. Doppler ultrasound, computerized tomography, angiography were performed for accurate diagnosis as well as wound and blood cultures were obtained.

Results: Primary operational charts were evaluated. Twenty-three patients required additional surgical interventions. Extraanatomical bypasses were performed in 11 patients. Aortobifemoral grafting was performed in 1 patient and aortobiliac bypass with superficial femoral vein grafting was performed in the other patient.The cultures were positive in 16 patients where metisillin-resistant Staphylococcus epidermidis was found 60% in this group. Overall hospital mortality was found as 12.8 (5 patients) and extremity loss as 15.4% (6 patients).

Conclusion: Early diagnosis and surgical intervention with proper antibiotics management remain the treatment of choice in preventing the life-threatening complications of prosthetic graft infections. (Turkish J Vasc Surg 2006;15(1):7-10).