Approach to Prosthetic Vascular Graft Infections and Alternative Treatments: Review of the Literature with Two Cases

The aim of this study is to discuss the prosthetic vascular graft (PVG) approach, which has been still widely used in peripheral arterial and aortic surgery, and the infections develop in the early or late postoperative periods. The classical way of treatment is considered as resection of the infected graft, wide debridement of necrotic tissues, obtaining bacterial cultures, revascularization with a different approach, and administration of suitable antibiotics. However, treatment strategy cannot be always applied due to several reasons related to the patient and/or the disease. As an alternative, prosthetic vascular graft infection (PVGI) can be done either with partial graft resection or with negative pressure wound therapy (the vacuum assisted wound closure) together with irrigation with antimicrobial solutions and without any resection. We reviewed the literature with two cases of our center. In PVGI, there are some treatment options other than resection and revascularization. PVGI has significantly high mortality and morbidity rates. More studies are needed to solve those problems, and make a consensus on diagnosis and treatment for vascular and cardiovascular surgeons.