Treatment of infective and potentially infective complications of vascular bypass grafting using gentamicin with collagen sponge.

The use of gentamicin with collagen sponge (GCS) in treating patients with infective and potentially infective complications of vascular bypass grafting was reviewed. GCS was used in 25 patients. These were: 11 in situ applications to a proven graft infection, 2 to a superficial wound infection over an underlying graft, 4 at removal of an infected prosthesis, 4 for a persistent lymphatic leak, 3 for an anastomotic aneurysm and one for an anastomotic dehiscence. The GCS was used with rifampicin-soaked collagen impregnated Dacron in 3 of these patients. Of the 11 in situ treatments of a graft infection with GCS, 7 infections were successfully aborted, 3 grafts were removed resulting in 2 patients losing a leg and one patient died before the outcome was known. None of the other patients treated with GCS subsequently had infective sequelae. GCS is a simple, safe and often effective treatment when dealing with these difficult complications of arterial surgery, the use of which requires greater recognition.