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Vacuum-assisted closure as a treatment modality for infrainguinal vascular prosthetic graft infection: our experience and take-home message


Authors: M. Pirkl 1,2;  T. Daněk 1;  Michal Černý 1 ;  A. Formelová 1
Authors place of work: Oddělení cévní a plastické chirurgie, Chirurgická klinika, Pardubická krajská nemocnice, a. s. přednosta: Doc. MUDr. J. Šiller, PhD. 1;  Fakulta zdravotnických studií Univerzity Pardubice, děkan: prof. MUDr. A. Pellant, DrSc. 2
Published in the journal: Rozhl. Chir., 2013, roč. 92, č. 5, s. 237-245.
Category: Review

Summary

Introduction:
Infection of the prosthetic graft represents one of the biggest challenges for practising vascular surgeons. The patient is jeopardized with possible future limb loss or, in the most serious cases, even death due to this complication. The incidence in the infrainguinal area amounts to a maximum of 6% of all arterial surgical procedures.

Material and methods:
Between January 2010 and December 2011, the authors performed a total of 689 vascular surgical reconstructions, of which 311 were performed in the infrainguinal area where 7 cases (2.25%) of graft infection occurred.

Results:
None of the patients died or lost a limb due to this complication. Two patients with an infected infrainguinal prosthetic graft were successfully treated with vacuum-assisted closure (VAC) system.

Conclusion:
The prosthetic vascular graft infection is the most feared complication in vascular surgery. The generally recognized principles of the traditional surgical approach are well-known and widely accepted. However, in selected cases of infrainguinal vascular prosthetic infection, both the affected limb and the patent graft may be saved and successfully treated with the use of vacuum-assisted closure.

Key words:
prosthetic graft infection – infection in vascular surgery – vacuum-assisted closure – VAC


Zdroje

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Štítky
Surgery Orthopaedics Trauma surgery
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