AN 8-YEAR EXPERIENCE OF CONSERVATIVE MANAGEMENT FOR AORTIC GRAFT SEPSIS

被引:19
作者
GORDON, A [1 ]
CONLON, C [1 ]
COLLIN, J [1 ]
PETO, T [1 ]
GRAY, D [1 ]
HANDS, L [1 ]
MORRIS, P [1 ]
机构
[1] JOHN RADCLIFFE HOSP,NUFFIELD DEPT SURG,OXFORD OX3 9DU,ENGLAND
来源
EUROPEAN JOURNAL OF VASCULAR SURGERY | 1994年 / 8卷 / 05期
关键词
GRAFT SEPSIS; AORTIC GRAFT; VASCULAR SURGERY;
D O I
10.1016/S0950-821X(05)80600-0
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
This paper describes the results of conservative management of 15 patients with aortic graft infection. The median time to presentation was 4 months. Six of eight grafts that were sent for culture grew organisms, of which the commonest were streptococci and coagulase negative staphylococci. Four patients did not receive intensive antibiotic treatment and all died of sepsis. Eleven patients received intensive intravenous and oral antibiotic therapy and appropriate surgical management; two of these died, one of a stroke and the other of an unknown cause. Two of the nine surviving patients had no surgery and the remainder had procedures to drain pus and unblock occluded grafts, including minimal graft excision in four patients, although two of these subsequently required total graft excision. The follow-up period for six of these nine patients is more than 4 years. For most patients with aortic graft infection aggressive antibiotic treatment supplemented by minimalist surgery is preferable to primary radical surgery. © 1994 W.B. Saunders Company Ltd.
引用
收藏
页码:611 / 616
页数:6
相关论文
共 30 条
[1]  
O'Brien, Collin, Prosthetic vascular graft infection, Br J Surg, 79, pp. 1262-1267, (1992)
[2]  
Shaw, Baue, Management of sepsis complicating arterial reconstructive surgery, Surgery, 53, pp. 75-85, (1963)
[3]  
Bandyk, Diagnosis and treatment of biomaterial-associated vascular infections, Infect Dis Clin N Am, 6, pp. 719-729, (1992)
[4]  
Sedwitz, Davies, Pretorius, Et al., Indium 111-labelled white blood cell scan after vascular prosthetic reconstruction, J Vasc Surg, 6, pp. 476-481, (1987)
[5]  
Lorentzen, Neilsen, Arendrup, Et al., Vascular graft infection: an analysis of sixty-two graft infections in 2411 consecutively implanted synthetic vascular grafts, Surgery, 98, pp. 81-86, (1985)
[6]  
Liekweg, Greenfield, Vascular prosthetic infections: collected experience and results of treatment, Surgery, 81, pp. 335-342, (1977)
[7]  
Bandyk, Berni, Thiele, Towne, Aortofemoral graft infection due to Staphylococcus epidermidis, Arch Surg, 119, pp. 102-108, (1984)
[8]  
Conn, Hardy, Chavez, Fain, Infected arterial grafts: experience in 22 cases with emphasis on unusual bacteria and techniques, Ann Surg, 171, pp. 704-714, (1970)
[9]  
Bunt, Synthetic vascular graft infections, Surgery, 93, pp. 733-746, (1983)
[10]  
Brook, Role of anaerobic bacteria in aortofemoral graft infection, Surgery, 104, pp. 843-845, (1988)