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Complex treatment of vascular prostheses infections

Infections after vascular reconstructions are very rare; however, when they occur, they are associated with a high risk of morbidity. In order to obtain the best results possible, the treatment needs to be initiated as early as possible, from the very first signs of infection, and it needs to be car...

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Autores principales: Andercou, Octavian, Marian, Dorin, Olteanu, Gabriel, Stancu, Bogdan, Cucuruz, Beatrix, Noppeney, Thomas
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Wolters Kluwer Health 2018
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6076048/
https://www.ncbi.nlm.nih.gov/pubmed/29979414
http://dx.doi.org/10.1097/MD.0000000000011350
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author Andercou, Octavian
Marian, Dorin
Olteanu, Gabriel
Stancu, Bogdan
Cucuruz, Beatrix
Noppeney, Thomas
author_facet Andercou, Octavian
Marian, Dorin
Olteanu, Gabriel
Stancu, Bogdan
Cucuruz, Beatrix
Noppeney, Thomas
author_sort Andercou, Octavian
collection PubMed
description Infections after vascular reconstructions are very rare; however, when they occur, they are associated with a high risk of morbidity. In order to obtain the best results possible, the treatment needs to be initiated as early as possible, from the very first signs of infection, and it needs to be carried out in centers specializing in vascular surgery. The aim of the present study was to assess the incidence of infections in a single university center. This retrospective analysis over a 2-year period is based on the medical reports of hospitalized patients who were diagnosed with infection following revascularization. From 2013 to 2014, a number of 151 open reconstructive surgical procedures were performed. 15 patients suffered from infection (10%) of the vascular reconstruction. Of these patients, 40% have had an aorto-bifemoral bypass, 53%—a femoro-popliteal bypass, and 7% (n = 1)—an axillo-femoral bypass. According to the Samson classification, the patients were categorized as follows: group 2: 6 cases, group 3: 2 cases, group 4: 4 cases, and group 5: 3 cases. The most frequent bacteria found were methicillin-resistant Staphylococcus aureus (MRSA) (n = 6, 40%), followed by S aureus (n = 5, 33%). The treatment options were: application of antibiotics alone without any invasive treatment in 3 patients, local irrigation and debridement in 6 patients, complete explantation of the prosthesis with a new extra-anatomic bypass in 6 cases, and partial excision of the prosthesis, which was replaced and covered with muscle flap, in 3 cases. The amputation rate in our study was 18%, which corresponds to the rates published in the literature. The treatment of infections in vascular surgery needs to be complex and adapted to each individual patient, because infections being in a permanent dynamic state. The treatment needs to be performed in specialized centers that have large experience in vascular surgery, in order for the patient to have the best chances of survival and protection from amputation.
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spelling pubmed-60760482018-08-17 Complex treatment of vascular prostheses infections Andercou, Octavian Marian, Dorin Olteanu, Gabriel Stancu, Bogdan Cucuruz, Beatrix Noppeney, Thomas Medicine (Baltimore) Research Article Infections after vascular reconstructions are very rare; however, when they occur, they are associated with a high risk of morbidity. In order to obtain the best results possible, the treatment needs to be initiated as early as possible, from the very first signs of infection, and it needs to be carried out in centers specializing in vascular surgery. The aim of the present study was to assess the incidence of infections in a single university center. This retrospective analysis over a 2-year period is based on the medical reports of hospitalized patients who were diagnosed with infection following revascularization. From 2013 to 2014, a number of 151 open reconstructive surgical procedures were performed. 15 patients suffered from infection (10%) of the vascular reconstruction. Of these patients, 40% have had an aorto-bifemoral bypass, 53%—a femoro-popliteal bypass, and 7% (n = 1)—an axillo-femoral bypass. According to the Samson classification, the patients were categorized as follows: group 2: 6 cases, group 3: 2 cases, group 4: 4 cases, and group 5: 3 cases. The most frequent bacteria found were methicillin-resistant Staphylococcus aureus (MRSA) (n = 6, 40%), followed by S aureus (n = 5, 33%). The treatment options were: application of antibiotics alone without any invasive treatment in 3 patients, local irrigation and debridement in 6 patients, complete explantation of the prosthesis with a new extra-anatomic bypass in 6 cases, and partial excision of the prosthesis, which was replaced and covered with muscle flap, in 3 cases. The amputation rate in our study was 18%, which corresponds to the rates published in the literature. The treatment of infections in vascular surgery needs to be complex and adapted to each individual patient, because infections being in a permanent dynamic state. The treatment needs to be performed in specialized centers that have large experience in vascular surgery, in order for the patient to have the best chances of survival and protection from amputation. Wolters Kluwer Health 2018-07-06 /pmc/articles/PMC6076048/ /pubmed/29979414 http://dx.doi.org/10.1097/MD.0000000000011350 Text en Copyright © 2018 the Author(s). Published by Wolters Kluwer Health, Inc. http://creativecommons.org/licenses/by-nc-nd/4.0 This is an open access article distributed under the terms of the Creative Commons Attribution-Non Commercial-No Derivatives License 4.0 (CCBY-NC-ND), where it is permissible to download and share the work provided it is properly cited. The work cannot be changed in any way or used commercially without permission from the journal. http://creativecommons.org/licenses/by-nc-nd/4.0
spellingShingle Research Article
Andercou, Octavian
Marian, Dorin
Olteanu, Gabriel
Stancu, Bogdan
Cucuruz, Beatrix
Noppeney, Thomas
Complex treatment of vascular prostheses infections
title Complex treatment of vascular prostheses infections
title_full Complex treatment of vascular prostheses infections
title_fullStr Complex treatment of vascular prostheses infections
title_full_unstemmed Complex treatment of vascular prostheses infections
title_short Complex treatment of vascular prostheses infections
title_sort complex treatment of vascular prostheses infections
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6076048/
https://www.ncbi.nlm.nih.gov/pubmed/29979414
http://dx.doi.org/10.1097/MD.0000000000011350
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