Methicillin-resistant Staphylococcus aureus: vascular surgeons should fight back.

Methicillin-resistant Staphylococcus aureus (MRSA) is now the commonest cause of serious vascular wound and graft infection in the U.K., and vascular departments in many other countries are similarly affected. There are no randomised trials that provide information about how to deal with this epidemic. There are, however, a number of clinical series that provide data that can be used to mount a logical and coherent response to the problem of preventing and managing MRSA infection. The risks and problems are different in every hospital and co-operation with local microbiologists is essential in creating individual protocols. Stratifying the risk to each patient is the first step; established antiseptic and surgical procedures are usually adequate as primary prevention. Studies into the role of targeted antibiotic therapy and isolation techniques are needed.