Literature DB >> 8028094

Antibiotic irrigation and conservative surgery for major aortic graft infection.

G E Morris1, P J Friend, D J Vassallo, M Farrington, S Leapman, C R Quick.   

Abstract

PURPOSE: Traditional surgical treatment for panprosthetic aortic graft infection entails radical excision of the graft, aortic stump closure, and extraanatomic revascularization of the lower limbs. This carries an early mortality rate of 24% to 45%. Amputation rates range from 11% to 37%. Multiple operations and prolonged hospital stay are usual. We have developed a more conservative management technique with the aim of improving outcome.
METHODS: We describe an innovative method of treating the condition with prolonged, high-dose, local antibiotic irrigation therapy, systemic antibiotic treatment, surgical debridement, and graft conservation in a prospectively studied series of 10 patients.
RESULTS: The actual 30-day patient survival rate is 90%, the 1-year survival rate is 80%, and the 4-year survival rate is 67%. Two patients died because of graft infection, and the third died, uninfected, of an unrelated cause. No limbs have been amputated. Only two patients required a second operation. Mean postoperative hospital stay was 32 days. The seven survivors have been closely followed up with regular computed tomography or indium scanning and clinical examination and appear to be free from infection at a mean of 61 months after cessation of irrigation therapy.
CONCLUSION: The technique appears to represent a significant improvement in the management of this major complication of vascular surgery.

Entities:  

Mesh:

Substances:

Year:  1994        PMID: 8028094     DOI: 10.1016/0741-5214(94)90179-1

Source DB:  PubMed          Journal:  J Vasc Surg        ISSN: 0741-5214            Impact factor:   4.268


  5 in total

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

Authors:  J Holdsworth
Journal:  Ann R Coll Surg Engl       Date:  1999-05       Impact factor: 1.891

2.  Conservative Treatment of an Infected Aortic Graft with Antibiotic Irrigation.

Authors:  M Akhtar; L Meecham; R Birkett; A D P Pherwani; J F Fairhead
Journal:  Int J Angiol       Date:  2015-06-05

3.  A novel approach for salvaging infected prosthetic mesh after ventral hernia repair.

Authors:  J A Trunzo; J L Ponsky; J Jin; C P Williams; M J Rosen
Journal:  Hernia       Date:  2009-02-12       Impact factor: 4.739

Review 4.  How To Diagnose and Manage Infected Endografts after Endovascular Aneurysm Repair.

Authors:  Carlo Setacci; Emiliano Chisci; Francesco Setacci; Leonardo Ercolini; Gianmarco de Donato; Nicola Troisi; Giuseppe Galzerano; Stefano Michelagnoli
Journal:  Aorta (Stamford)       Date:  2014-12-01

5.  Infective endocarditis complicated by aortic graft infection and osteomyelitis: case report and review of literature.

Authors:  Elie Zouein; Robert Wetz; Neville Mobarakai; Samer Hassan; Iris Tong
Journal:  Int J Gen Med       Date:  2012-07-05
  5 in total

北京卡尤迪生物科技股份有限公司 © 2022-2023.