Skin sliding closure technique is effective for management of infected prostheses in cases of arterial reconstruction with synthetic grafts.

A clinical review of 400 prosthetic arterial reconstructions, carried out in the Second Department of Surgery of Kyushu University Hospital during a period from 1965 to 1981, revealed 10 graft infections (2.5 per cent). There were two out of 120 abdominal aneurysms (1.7 per cent) and 8 out of 260 aorto-femoral occlusive diseases (3.1 per cent). The contributing factors included intraoperative contamination with duodenal juice during surgery for abdominal aneurysms ruptured into the duodenum (2 cases), minor hematoma and/or lymphorrhoea at the groin or lower abdominal wall (5 cases), wound infection (1 case), compression necrosis of the sigmoid colon by the implanted graft (1 case) or perityphlitic abscess due to a perforating appendicitis (1 case). Bacteriologic examination revealed a predominance of a variety of staphylococcus at the groin or lower abdominal wall and E. coli in the abdominal cavity. Four patients expired. Limb amputation had to be done in 2, and 4 were cured. In the management of infected graft at the groin or lower abdominal wall, we used with success a skin sliding closure technique after continuous wound lavage in 3 patients.