Vascular prosthetic infections: collected experience and results of treatment.

A review of 178 published cases of infected vascular prosthetic grafts through 1974 disclosed 164 sufficiently well documented for review. The time and manner of presentation depended on location and most commonly included localized wound infection with graft exposure. Staphylococcus aureus was the most common organism cultured and predisposing infection in the foot or opposite groin was significant. The over-all mortality rate was 52 of 153 patients (33.9 percent), separating into 47.9 percent at the aortofemoral (AF) level and 9.9 percent for femoropopliteal (FP) infections. Amputation rate was 23 percent for AF and 36 percent for FP infections. Of five treatment plans utilized. best results were obtained with early exploration and revascularization. Conservative treatment of FP grafts was successful when the graft was patent. At the Medical College of Virginia, the graft infection rate was 2.6 percent and the mortality rate was 36 percent. Conservative treatment efforts without revascularization resulted in a 57 percent amputation rate and justifies a more aggressive approach to suspected graft infection.