Ovine Biosynthetic Grafts for Aortoiliac Reconstructions in Nonsterile Operative Fields

2021 ◽  
Author(s):  
Hazem El Beyrouti ◽  
Mohammad Bashar Izzat ◽  
Angela Kornberger ◽  
Nancy Halloum ◽  
Kathrin Dohle ◽  
...  
Keyword(s):  
Treatment Group ◽  
Vascular Grafts ◽  
Graft Infection ◽  
Prosthetic Graft ◽  
Vascular Graft Infection ◽  
Vascular Prostheses ◽  
Graft Thrombosis ◽  
Life Threatening ◽  
Omniflow Ii

Abstract Background Prosthetic vascular grafts placed surgically or via endovascular techniques can be subject to the risk of life-threatening graft infections. The Omniflow II vascular prosthesis is a biosynthetic graft that was reported to have favorable properties in resisting infections. Materials and Methods We retrospectively reviewed our 3 years' experience of using the Omniflow II prostheses for aortoiliac reconstructions in patients considered to carry a substantial risk of subsequent prosthetic graft infections (prevention group) as well as in patients with actively infected prosthetic vascular grafts (treatment group). Results Aorto-bi-iliac (n = 4) and aortobifemoral (n = 12) vascular reconstructions were performed using bifurcated Omniflow II prostheses in nine patients in the prevention group and seven patients in the treatment group. During mean follow-up of 28.6 ± 17.2 months, there was one case of graft infection (6.3%) and graft thrombosis (6.3%) with subsequent successful thrombectomy. Early and late surgical revisions were required in eight (50%) and two (12.6%) patients, respectively. All graft prostheses were patent at last follow-up. Conclusion Using bifurcated Omniflow II vascular prostheses in patients with or at a high risk of vascular graft infection is advisable, and is associated with acceptable reinfection and patency rates.

scholarly journals Biosynthetic vascular graft: a valuable alternative to traditional replacement materials for treatment of prosthetic aortic graft infection?

2018 ◽  
Vol 108 (4) ◽  
pp. 291-296 ◽  
Author(s):  
T. Betz ◽  
D. Neuwerth ◽  
M. Steinbauer ◽  
C. Uhl ◽  
K. Pfister ◽  
...  
Keyword(s):  
Perioperative Complications ◽  
Vascular Grafts ◽  
Graft Infection ◽  
Prosthetic Graft ◽  
Graft Material ◽  
Aortic Graft ◽  
Valuable Alternative ◽  
Aortic Graft Infection ◽  
Omniflow Ii

Background and Aims: To report the experience of a tertiary vascular surgery center using Omniflow II® biosynthetic vascular grafts for treatment of prosthetic aortic graft infection. Materials and methods: Retrospective analysis of all patients with prosthetic graft infections who underwent in situ aortic reconstruction using Omniflow II® grafts or other conduits between March 2015 and May 2017. Early and late mortality, perioperative complications, and reinfection rate were analyzed. Results: Sixteen patients (14 males, median age 68.5, range 57–89) with prosthetic aortic graft infection were treated at our center. Eight patients received an Omniflow II® biosynthetic graft, two patients silver-triclosan coated grafts, three patients bovine pericardial tube grafts, and three patients composite bovine pericardial tube grafts with Omniflow II® graft extensions. Perioperative complications occurred in seven patients (43.8%). Early mortality rate was 18.7% (n = 3). In addition, four patients died during follow-up after a median of 11 months (range 0–34 months). We did not observe any reinfections. Bypass grafts were patent in all patients. No major limb amputations were performed during follow-up. Conclusion: Treatment of prosthetic aortic graft infection with Omniflow II® vascular grafts is feasible. Graft material seems to have an excellent resistance to infection and might be a valuable alternative to traditional replacement materials. Especially long-term durability has to be continuously monitored and documented.

scholarly journals Temporin A Soaking in Combination with Intraperitoneal Linezolid Prevents Vascular Graft Infection in a Subcutaneous Rat Pouch Model of Infection with Staphylococcus epidermidis with Intermediate Resistance to Glycopeptides

2004 ◽  
Vol 48 (8) ◽  
pp. 3162-3164 ◽  
Author(s):  
Andrea Giacometti ◽  
Oscar Cirioni ◽  
Roberto Ghiselli ◽  
Fiorenza Orlando ◽  
Giuseppina D'Amato ◽  
...  
Keyword(s):  
Staphylococcus Epidermidis ◽  
Vascular Graft ◽  
Graft Infection ◽  
Prosthetic Graft ◽  
Vascular Graft Infection ◽  
Methicillin Resistant ◽  
Prosthetic Graft Infection ◽  
Intermediate Resistance ◽  
Temporin A

ABSTRACT The efficacy of linezolid and temporin A in the prevention of prosthetic graft infection due to methicillin-resistant Staphylococcus epidermidis with intermediate resistance to glycopeptides was investigated in a subcutaneous rat pouch model. Linezolid and temporin A, alone or combined, greatly reduced the bacterial numbers compared to the effect with control drugs.

Staphylococcus-induced glomerulonephritis: potential role for corticosteroids

2021 ◽  
Vol 14 (1) ◽  
pp. e237011
Author(s):  
Rui Filipe Nogueira ◽  
Nuno Oliveira ◽  
Vítor Sousa ◽  
Rui Alves
Keyword(s):  
Kidney Function ◽  
Potential Role ◽  
Graft Infection ◽  
Clinical Manifestations ◽  
Rapidly Progressive Glomerulonephritis ◽  
Vascular Graft Infection ◽  
Systemic Corticosteroids ◽  
Life Threatening ◽  
Stage Renal Disease ◽  
End Stage

Staphylococcus aureus is a troublesome pathogen, responsible for a broad range of clinical manifestations, ranging from benign skin infections to life-threatening conditions such as endocarditis and osteomyelitis. The kidney can be affected through a rapidly progressive glomerulonephritis mediated by an inflammatory reaction against a superantigen deposited in the glomerulus during the infection’s course. This glomerulopathy has a poor prognosis, often leading to chronically impaired kidney function, eventually progressing to end-stage renal disease. Treatment rests on antibiotherapy. Despite the inflammatory role in this disease’s pathophysiology, most authors discourage a simultaneous immunosuppressive approach given the concomitant infection. However, there are some reports of success after administration of systemic corticosteroids in these patients. We present a 66-year-old man with a staphylococcus-induced glomerulonephritis brought on by a vascular graft infection, with rapidly deteriorating kidney function despite extraction of the infected graft and 3 weeks of antibiotherapy with achievement of infection control. Kidney function improved after the introduction of corticosteroids. This case highlights the potential role of corticosteroids in selected cases of staphylococcus-induced glomerulonephritis, particularly those in which the infection is under control.

Which prosthesis is more resistant to vascular graft infection: polytetrafluoroethylene or Omniflow II biosynthetic grafts?

Surgery Today ◽  
2015 ◽  
Vol 46 (3) ◽  
pp. 363-370 ◽  
Author(s):  
Orhan Bozoglan ◽  
Bulent Mese ◽  
Erdinc Eroglu ◽  
Serdal Elveren ◽  
Mustafa Gul ◽  
...  
Keyword(s):  
Vascular Graft ◽  
Graft Infection ◽  
Vascular Graft Infection ◽  
Omniflow Ii

Management and Outcome of Prosthetic Vascular Graft Infections: A Single Center Experience

2018 ◽  
Vol 52 (3) ◽  
pp. 181-187 ◽  
Author(s):  
Maxime Elens ◽  
Muzhakkir Dusoruth ◽  
Parla Astarci ◽  
Stefano Mastrobuoni ◽  
Michel J. Bosiers ◽  
...  
Keyword(s):  
Vascular Graft ◽  
Graft Infection ◽  
Prosthetic Graft ◽  
Long Term Results ◽  
High Morbidity ◽  
Vascular Graft Infection ◽  
Complete Excision ◽  
Single Center Experience ◽  
Initial Surgery ◽  
Prosthetic Vascular Graft Infection

Background: Prosthetic vascular graft infection (PVGI) remains a severe and challenging complication in vascular surgery with high morbidity and mortality rates. Incidence has been reported between 1% and 6%. The aim of this study was to report our experience in terms of general and surgical management as well as outcome, over 15 years. Methods: A retrospective consecutive study was conducted of all patients treated in our department for PVGI between January 2000 and December 2015. We analyzed all data relative to primary operation, duration interval between initial surgery and infections signs, infection site, type of microorganism involved, and surgical treatment modality, as well as evaluation of short- and long-term results. Results: Sixty-two patients were admitted for PVGI. Primary revascularization procedures consisted of a peripheral bypass in 42 (68%) patients and an aortic bypass in the remaining 20 (32%) patients. Median interval between primary procedure and reintervention was 3 months (interquartile range 17 [IQR 17]) in the peripheral group and 48 months (IQR 70.5) in the aortic group. Complete excision of the prosthetic graft was carried out in 85% of the cases. Thirty-day mortality was 0% and 9.5% in the aortic and peripheral group, respectively. The overall survival rate was 62.3% at 2-years, 46.4% in the aortic group, and 69.7% in the peripheral group. Conclusions: Prosthetic vascular graft infection needs a multidisciplinary management with appropriate antibiotherapy, radical removal of the infected graft, and in situ reconstruction. This strategy gives satisfactory results in terms of mortality, morbidity, patency rates, and infection control.

Rotational muscle flaps to treat localized prosthetic graft infection: Long-term follow-up

1993 ◽  
Vol 18 (3) ◽  
pp. 358-365 ◽  
Author(s):  
John C. Motta ◽  
Bruce A. Perler ◽  
Craig A. Vender Kolk ◽  
Paul M. Manson
Keyword(s):  
Graft Infection ◽  
Prosthetic Graft ◽  
Muscle Flaps ◽  
Prosthetic Graft Infection ◽  
Long Term Follow Up

Graft for Mycotic Thoracic Aortic Aneurysm: Omental Wrapping to Prevent Infection

2005 ◽  
Vol 13 (1) ◽  
pp. 11-16 ◽  
Author(s):  
Yukio Kuniyoshi ◽  
Kageharu Koja ◽  
Kazufumi Miyagi ◽  
Tooru Uezu ◽  
Satoshi Yamashiro ◽  
...  
Keyword(s):  
Aortic Aneurysm ◽  
Thoracic Aortic Aneurysm ◽  
Graft Infection ◽  
Prosthetic Graft ◽  
Omental Flap ◽  
Thoracoabdominal Aorta ◽  
Omental Wrapping ◽  
Hospital Deaths

Nine cases of mycotic thoracic aortic aneurysm were treated surgically between July 1995 and March 2003. The aneurysms were located in the ascending aorta in 1 patient, the descending thoracic aorta in 5, and the thoracoabdominal aorta in 3. Preoperatively, 3 patients were in shock due to rupture of the aneurysm. All patients underwent aneurysmectomy and in-situ graft placement. In 5 patients, the graft was covered with a pedicled omental flap to prevent postoperative graft infection. There were 2 hospital deaths: one patient died of multi-organ failure, and the other died from intrathoracic bleeding. After discharge, one patient died from intrathoracic bleeding 3 months after surgery. These 3 patients had not received omental wrapping. Postoperative graft infection did not occur in the 6 surviving patients during a mean follow-up period of 4.0 ± 3.1 years. It was concluded that covering the prosthetic graft with a pedicled omental flap may help prevent postoperative graft infection and improve the surgical results.

scholarly journals Efficacy of Quinupristin-Dalfopristin in Preventing Vascular Graft Infection Due to Staphylococcus epidermidis with Intermediate Resistance to Glycopeptides

2002 ◽  
Vol 46 (9) ◽  
pp. 2885-2888 ◽  
Author(s):  
Andrea Giacometti ◽  
Oscar Cirioni ◽  
Roberto Ghiselli ◽  
Fiorenza Orlando ◽  
Federico Mocchegiani ◽  
...  
Keyword(s):  
Rat Model ◽  
Staphylococcus Epidermidis ◽  
Subcutaneous Tissue ◽  
Graft Infection ◽  
Prosthetic Graft ◽  
Control Group ◽  
Vascular Graft Infection ◽  
Prosthetic Graft Infection ◽  
Intermediate Resistance

ABSTRACT A rat model was used to investigate the efficacy of quinupristin-dalfopristin (Q-D) in the prevention of vascular prosthetic graft infection due to methicillin-resistant Staphylococcus epidermidis with intermediate resistance to glycopeptides. The in vitro activity of the compound was compared to that of vancomycin by MIC determination and time-kill study. Moreover, the efficacy of collagen-sealed Q-D-soaked Dacron was evaluated in a rat model of graft infection. Graft infections were established in the subcutaneous tissue of the backs of 120 adult male Wistar rats. The in vivo study included a control group, one contaminated group that did not receive any antibiotic prophylaxis, two contaminated groups that received grafts soaked with 10 and 100 μg of Q-D per ml, respectively, and two contaminated groups that received grafts soaked with 10 and 100 μg of vancomycin per ml, respectively. Rats that received Dacron grafts soaked with 100 μg of Q-D per ml showed no evidence of infection (<10 CFU/ml). In contrast, for rats that received Dacron grafts soaked with 10 μg of Q-D per ml and Dacron grafts soaked with 10 or 100 μg of vancomycin per ml, the quantitative graft cultures demonstrated 2.2 × 102 ± 1.3 × 102, 2.2 × 106 ± 1.9 × 105, and 5.6 × 102 ± 0.3 × 102 CFU/ml, respectively. Taken together the results of the study demonstrate that the use of Dacron grafts soaked with Q-D can result in significant bacterial growth inhibition and show that this compound is potentially valuable for prevention of vascular prosthetic graft infection.

scholarly journals Rotational muscle flaps to treat localized prosthetic graft infection: Long-term follow-up

1993 ◽  
Vol 18 (3) ◽  
pp. 358-365 ◽  
Author(s):  
Bruce A. Perler ◽  
Craig A. Vender Kolk ◽  
Paul M. Manson ◽  
G.Melville Williams
Keyword(s):  
Graft Infection ◽  
Prosthetic Graft ◽  
Muscle Flaps ◽  
Prosthetic Graft Infection ◽  
Long Term Follow Up

Multi-Component Solar Protection Interventions: The Impact of Modelling and “Trickle Down”?

1997 ◽  
Vol 9 ◽  
pp. 48-68
Author(s):  
Christopher J. Gregory ◽  
Nick Higginbotham ◽  
John D. Shea
Keyword(s):  
Treatment Group ◽  
Skin Cancer ◽  
Technical College ◽  
Composite Index ◽  
Ultra Violet ◽  
Test Occasion ◽  
Post Test ◽  
Life Threatening ◽  
The Impact

AbstractWorkers in outdoor occupations routinely face unavoidable exposure to the sun's ultra violet rays with attendant risk of skin cancer, and this study evaluated a multi-faceted education program aimed at improving the solar protection practices of Australian Technical College Surveying students performing outdoor field exercises. One hundred and fifteen students were randomly assigned (by class) to either a Control or Treatment group, and given slides, information sheets, and a guest talk by a young woman who had recovered from life-threatening skin cancer, with a baseline and two follow-up assessments being made on field days using a behavioural diary. A greater proportion of students receiving the solar education increased sunscreen cream application and hat use compared with Control participants, and a composite index of solar protection favoured the Treatment group. Moreover, Control participants significantly changed some solar protection behaviours, possibly through modelling the Treatment group, and Treatment participants showed significantly higher rates of particular sun protection behaviours at the second post test occasion than at the first post test occasion.

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