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Prosthetic vascular graft infections: a center experience

机译:人工血管移植感染:中心经验

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Introduction: Prosthetic graft infection is a major complication of vascular surgery associated with high morbid-mortality rates. This retrospective non-randomized single center study evaluated our experience in the management of prosthetic vascular graft infections. Methods: We review the clinical files of patients who had vascular grafts implanted at our center between June 2007 and December 2011 and analysed the cases that developed Samson group 3, 4 and 5 infections until December 2012. Results: From June 2007 to December 2012, 18 consecutive patients (14 males, 4 females) with median age 70 years were admitted to our institution with the diagnosis of vascular graft infection accounting for an incidence of 3.8%. 50% of these infections were early infections and MRSA was the most prevalent pathogen. 44% of infections were due to infection of a femoro-popliteal bypass. Using Samson classification, 72% were group 4 and 5 infections. We performed graft preservation in one patient, graft excision without revascularization in 50% (nine) patients; Excision + insitu replacement in 39% (seven) patients; Excision + Extra-anatomic bypass in one patient. Our amputation rate was 55% and our related death rate was 16%. Conclusions: Our amputation and mortality rates are according the published reviews. Besides allowing recognition of our reality this offers the opportunity to review diagnosis and therapeutic issues in prosthetic vascular graft infections. Each situation needs to be individualized as there is no consensus nor guiding algorithms about what should be the best medical treatment
机译:简介:人工移植物感染是血管外科手术的主要并发症,发病率高。这项回顾性非随机单中心研究评估了我们在人工血管移植感染管理方面的经验。方法:我们回顾了2007年6月至2011年12月在我们中心植入血管移植物的患者的临床资料,并分析了直到2012年12月发生Samson组3、4和5感染的病例。结果:从2007年6月至2012年12月,中位年龄为70岁的连续18例患者(男性14例,女性4例)入院,诊断为血管移植物感染,发生率为3.8%。这些感染中有50%是早期感染,MRSA是最普遍的病原体。 44%的感染归因于股pop搭桥的感染。根据Samson分类,第4组和第5组感染占72%。我们对一名患者进行了移植物保存,对50%(九名)患者进行了无血运重建的切除。 39%(七名)患者行切除+原位置换;一名患者行Excision +解剖外旁路。我们的截肢率为55%,相关的死亡率为16%。结论:我们的截肢率和死亡率根据已发表的评论。除了让我们认识到现实之外,这还提供了机会来审查人工血管移植感染中的诊断和治疗问题。每种情况都需要个性化,因为对于什么应该是最好的治疗没有共识或指导算法

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