Management of infected arterial grafts

Management of infected arterial grafts Download PDF EPUB FB2

Management of infected arterial grafts Keith D. Calligaro, Frank J. Veith, St. Louis,Quality Medical Publishing, pages, $ Arterial graft infections pose many difficulties for the vascular surgeon, and this new book devoted to the problem of graft infection will serve as a valuable : Richard A.

Yeager. Additional Physical Format: Online version: Management of infected arterial grafts. Louis, Mo.: Quality Medical Pub., (OCoLC) Document Type. The introduction of prosthetic grafts has revolutionised the management of vascular disease but graft infection although uncommon, remains a dreaded complication Author: Mauro Vicaretti.

Management of Infected Arterial Grafts Fred J. Wolma, MD, Galveston, Texas John R. Derrick, MD, Galveston, Texas James McCoy, MD, Galveston, Texas One of the most challenging complications en- countered in vascular surgery is infection of arteri- al grafts. Despite the numerous reports on this subject two questions have not clearly been an- by: 4.

The management of infected vascular grafts and the impact of this complication on patient outcomes vary with the surgical site, although the clinical sequelae can be catastrophic. In general, treatment entails broad spectrum antibiotics and wide debridement of infected tissues, including removal of the graft (Table 2).Cited by: Address reprint requests to: Peter F.

Lawrence, MD, University of Utah Medical Center, Division of Vascular Surgery, 50 North Medical Drive, Salt Lake City, UT Management of Infected Aortic Grafts Peter F. Lawrence, MD Division of Vascular Surgery, Department of Surgery, University of Utah Medical Center, Salt Lake City, Utah Division of Vascular Surgery, Department of Surgery, University Cited by: The objective of this study was to evaluate the effectiveness of cryopreserved arterial homografts for management of prosthetic graft infection.

Between October and July90 patients (84 men) with a mean age of 64 years from six different hospitals were treated for prosthesis infection by in situ replacement using a cryopreserved Cited by: The management of infected prosthetic vascular grafts continues to be controversial.

The purpose of this study was to review the surgical management of major extracavitary prosthetic vascular graft infections and to correlate the outcomes on the basis of bacteriology and grade. to us for management of a wound infection involving an arterial graft that had been inserted elsewhere. In a review of infrainguinal reconstructions (fern- oropopliteal and femorotibial) that we performed be- tween November and March i, 12 patients had infections of grade III severity or greater for a.

Thirty patients (17 male, 13 female) underwent SMF for groin infection, which included infections of 22 artificial femoral bypass grafts (including 2 cryoveins) and 5 common femoral patch grafts, and 3 lymphocele infections (2 cardiac catheterizations and 1 penile cancer lymph node dissection).

The frequency of VGI depends on the anatomic location of the graft. The infection rate is % to 2% for most extracavitary grafts and as high as 6% with vascular grafts in the groin.

1–9 For intracavitary grafts, the infection rate is ≈1% to 5%. 1–6 Graft infection is most common after emergency procedures and after reoperation.1–4, The case notes of patients who underwent surgery and arterial grafting between the years of and at the University of Rochester Medical Center have been analyzed.

There were 15 cases of infected grafts-a rate of %. The outcome of the infection was determined in 12 of these cases. Four patients had no surgical treatment and all 4 by: Lower limb graft infection more commonly presents beyond 4 months, and aortic graft infection may present years later.

69 Intraoperative contamination of the graft with skin flora may occur in as many as 56% of arterial grafts, 70 implying this as the likely route of acquisition for the majority of graft infections.

Contiguous spread from local. Subtotal graft excision (SGE) was defined as removal of all of the graft with the exception of an oversewn cuff of prosthetic material on an underlying patent artery.8, 9, 10 Similar to our experience with infected peripheral bypass grafts, this strategy was employed if the arterial anastomosis was intact and encased in scar tissue.8 By.

CONTENTS Physiology Prevention Diagnosis Management Overall strategy Empiric antibiotic selection Pathogen-specific treatment Specific situations Septic thrombophlebitis Arterial line infection Chest port infection Algorithm Podcast Questions & discussion Pitfalls PDF of this chapter (or create customized PDF) various mechanisms of infection: Early infections often arise from the skin:.

In situ replacement: Low-grade infections without sepsis or invasive infection and those with distal occlusive disease may be best treated with in situ graft replacement.

Graft replacement material Graft material should be considered prior to surgery to ensure availability. Potential options for graft material include the following: Autogenous vein (saphenous vein, cephalic vein, basilic vein. During the past 15 years, we have employed a modified classification and management plan to treat infections involving nonaortic peripheral prosthetic grafts (PAPGs) without graft removal whenever possible.

Sixty-eight infected wounds potentially involving PAPGs were initially treated by excision of necrotic and infected wound tissue in the operating room (wound excision).Cited by: The infected graft, artery or vein is removed and replaced with another graft soaked in antibiotics, or with a section of one of your own veins, or with a cadaver vein.

If the affected artery or graft is blocked and you don’t need it, the infected graft can be removed without being replaced.

EMERGENCY SURGERY is rare, but sometimes needed. Akoh J. Prosthetic arteriovenous grafts for hemodialysis.

J Vasc Access ; Lin P, et al. Management of infected hemodialysis access grafts using cryopreserved human vein allografts.

Am J Surg ; Matsuura J. Cryopreserved human femoral vein: a new option for infected access grafts. Contemp Dial & Neph The traditional management of infected prosthet-ic arterial grafts includes total graft excision, over-sewing or ligation of the involved arteries, debride-ment of infected tissue, and revascularization when necessary to achieve limb salvage.1 However, when maintaining patency of an involved artery.

For infected aortic grafts, there are several options for treatment, including graft excision with extra-anatomic bypass, in situ reconstruction, or reconstruction with the neo-aortoiliac system.

The management of infected endovascular aortic grafts is similar. For infected peripheral bypasses, graft preservation techniques can be utilized, but in.This report of 25 patients with prosthetic graft infection has compared the diagnosis, management, and outcome in 14 patients with infected aortic grafts with 11 patients with infected peripheral.Full text Full text is available as a scanned copy of the original print version.

Get a printable copy (PDF file) of the complete article (K), or click on a page image below to browse page by : Linda de Cossart.