Prosthetic infection: lessons from treatment of the infected vascular graft.

Surgical prosthetics provide unquestioned benefit to patients in maintenance of life and limb. However, complications associated with prosthetic devices continue to represent a significant source of morbidity and mortality. Even as the surgeon becomes more adept at management of infections, the bacterial characteristics change in favor of increased virulence and greater resistance to antimicrobials. Excision or retention of the prosthesis depends on the time of presentation, the microbial isolates recovered, and the extent of surrounding tissue destruction. Recent work shows improving results with in situ replacement.