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Use of a Silver-Impregnated Vascular Graft: Single-Center Experience

Introduction: Vascular graft infection is a life threatening situation with significant morbidity and mortality. Bacterial graft infection can lead to false aneurysms, bleeding and sepsis. There are a lot of risky situations where grafts can become infected. It is therefore highly desirable to have...

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Autores principales: Molacek, Jiri, Treska, Vladislav, Houdek, Karel, Opatrný, Václav, Certik, Bohuslav, Baxa, Jan
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8944627/
https://www.ncbi.nlm.nih.gov/pubmed/35326849
http://dx.doi.org/10.3390/antibiotics11030386
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author Molacek, Jiri
Treska, Vladislav
Houdek, Karel
Opatrný, Václav
Certik, Bohuslav
Baxa, Jan
author_facet Molacek, Jiri
Treska, Vladislav
Houdek, Karel
Opatrný, Václav
Certik, Bohuslav
Baxa, Jan
author_sort Molacek, Jiri
collection PubMed
description Introduction: Vascular graft infection is a life threatening situation with significant morbidity and mortality. Bacterial graft infection can lead to false aneurysms, bleeding and sepsis. There are a lot of risky situations where grafts can become infected. It is therefore highly desirable to have a vascular graft that is resistant to infection. In this retrospective clinical study, a silver-impregnated vascular graft was evaluated in various indications. Methods: Our study included a total of 71 patients who received a silver-impregnated vascular graft during the period from 2013 to 2018. Patients had an aortoiliac localization of vascular graft in 61 cases (86%), and a peripheral localization on the lower limbs in 10 cases (14%). Indications for the use of these special vascular grafts were trophic lesions or gangrene in the lower limbs in 24 cases (34%), suspicious mycotic abdominal aortic aneurysm (mAAA) in 4 cases (5.5%), salmonela aortitis or aneurysms in 4 cases (5.5%), infection of the previous vascular graft in 11 cases (15.5%), other infections in 12 cases (17%), AAA rupture in 10 cases (14%) and other reasons (pre-transplant condition, multiple trauma, graft-enteric fistula) in 6 cases (8.5%). Thirty-day mortality, morbidity, the need for reintervention and amputation, primary and secondary graft patency, and finally the presence of a proven vascular graft infection were evaluated. Results: The 30-day mortality was 19.7%, and morbidity was 42.2%. The primary patency of the vascular graft was 91.5%. Reoperation was necessary in 10 cases (14%) and amputation was necessary in 10 cases (14%). The median length of hospital stay was 13 days and the mean follow-up period was 48 ± 9 months. During the follow-up period, six patients (8.5%) died from reasons unrelated to surgery or without any relation to the vascular graft. Secondary patency after one year was 88%. Infection of the silver graft was observed in three patients (4.2%). Conclusions: Based on our results, the silver graft is a very suitable alternative for solving infectious, or potentially infectious, situations in vascular surgery. In particular, in urgent or acute cases, a silver graft is often the only option.
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spelling pubmed-89446272022-03-25 Use of a Silver-Impregnated Vascular Graft: Single-Center Experience Molacek, Jiri Treska, Vladislav Houdek, Karel Opatrný, Václav Certik, Bohuslav Baxa, Jan Antibiotics (Basel) Article Introduction: Vascular graft infection is a life threatening situation with significant morbidity and mortality. Bacterial graft infection can lead to false aneurysms, bleeding and sepsis. There are a lot of risky situations where grafts can become infected. It is therefore highly desirable to have a vascular graft that is resistant to infection. In this retrospective clinical study, a silver-impregnated vascular graft was evaluated in various indications. Methods: Our study included a total of 71 patients who received a silver-impregnated vascular graft during the period from 2013 to 2018. Patients had an aortoiliac localization of vascular graft in 61 cases (86%), and a peripheral localization on the lower limbs in 10 cases (14%). Indications for the use of these special vascular grafts were trophic lesions or gangrene in the lower limbs in 24 cases (34%), suspicious mycotic abdominal aortic aneurysm (mAAA) in 4 cases (5.5%), salmonela aortitis or aneurysms in 4 cases (5.5%), infection of the previous vascular graft in 11 cases (15.5%), other infections in 12 cases (17%), AAA rupture in 10 cases (14%) and other reasons (pre-transplant condition, multiple trauma, graft-enteric fistula) in 6 cases (8.5%). Thirty-day mortality, morbidity, the need for reintervention and amputation, primary and secondary graft patency, and finally the presence of a proven vascular graft infection were evaluated. Results: The 30-day mortality was 19.7%, and morbidity was 42.2%. The primary patency of the vascular graft was 91.5%. Reoperation was necessary in 10 cases (14%) and amputation was necessary in 10 cases (14%). The median length of hospital stay was 13 days and the mean follow-up period was 48 ± 9 months. During the follow-up period, six patients (8.5%) died from reasons unrelated to surgery or without any relation to the vascular graft. Secondary patency after one year was 88%. Infection of the silver graft was observed in three patients (4.2%). Conclusions: Based on our results, the silver graft is a very suitable alternative for solving infectious, or potentially infectious, situations in vascular surgery. In particular, in urgent or acute cases, a silver graft is often the only option. MDPI 2022-03-15 /pmc/articles/PMC8944627/ /pubmed/35326849 http://dx.doi.org/10.3390/antibiotics11030386 Text en © 2022 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
spellingShingle Article
Molacek, Jiri
Treska, Vladislav
Houdek, Karel
Opatrný, Václav
Certik, Bohuslav
Baxa, Jan
Use of a Silver-Impregnated Vascular Graft: Single-Center Experience
title Use of a Silver-Impregnated Vascular Graft: Single-Center Experience
title_full Use of a Silver-Impregnated Vascular Graft: Single-Center Experience
title_fullStr Use of a Silver-Impregnated Vascular Graft: Single-Center Experience
title_full_unstemmed Use of a Silver-Impregnated Vascular Graft: Single-Center Experience
title_short Use of a Silver-Impregnated Vascular Graft: Single-Center Experience
title_sort use of a silver-impregnated vascular graft: single-center experience
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8944627/
https://www.ncbi.nlm.nih.gov/pubmed/35326849
http://dx.doi.org/10.3390/antibiotics11030386
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