Community Hospital Experience With Bovine Tissue in Infected Vascular Fields

2020 ◽  
pp. 000313482095281
Author(s):  
Patrick Sowa ◽  
Michael Soult ◽  
Matthew Blecha
Keyword(s):  
Community Hospital ◽  
Graft Infection ◽  
Prosthetic Graft ◽  
Causative Organism ◽  
High Morbidity ◽  
Wound Debridement ◽  
Prosthetic Graft Infection ◽  
Hospital Experience ◽  
Bovine Tissue

Background Vascular prosthetic graft infections are rare but associated with high morbidity and mortality. Treatment involves removal of the infected graft requiring arteriotomy closure. Previously this was performed with autologous graft, but bovine tissue has increasingly been used. The objective of this paper is to review the community hospital experience with bovine tissue repair in an infected vascular field. Materials and Methods A retrospective review of all cases performed by a single surgeon in a community hospital for infected prosthetic grafts was completed. Sixteen cases were included where bovine tissue was used for repair. Presentation, location of graft, and causative organism were reviewed, and outcomes including reoperation and mortality were recorded. Results Of the 16 patients, 15 (94%) had positive cultures of the graft. Methicillin-Resistant Staph Aureus was the most commonly isolated organism (50%). There were 3 unplanned reoperations including a revision from below to above knee amputation, drainage of a hematoma, and a wound debridement within the first year. Over the 1 year follow up period, 3 patients died for a mortality of 19%. There were no reinfections during follow-up. Discussion Prosthetic graft infection is a rare but serious vascular surgery complication. The causative organism has shifted in the last few years to become increasingly drug resistant. Treatment requires excision, and bovine tissue has been demonstrated to provide a safe and durable method of repair.

The safety of bovine tissue arterial repair in removal of infected prosthetic hemodialysis grafts

2020 ◽  
pp. 112972982094787
Author(s):  
Patrick Sowa ◽  
Peggie Halandras ◽  
Matthew Blecha
Keyword(s):  
Graft Infection ◽  
Morbidity And Mortality ◽  
Causative Organism ◽  
Arteriovenous Graft ◽  
Significant Morbidity ◽  
Autologous Vein ◽  
Wound Debridement ◽  
Bovine Tissue ◽  
Arterial Repair

Background: More than 400,000 Americans require dialysis, and many receive it via a prosthetic arteriovenous graft. Infection of these grafts is rare, but associated with significant morbidity and mortality. The gold standard is total graft excision with arteriotomy closure. This was previously done with autologous vein, but bovine tissue offers a reasonable alternative. The objective of this article is to evaluate a community hospital experience with bovine tissue arterial repair after total graft excision of infected prosthetic arteriovenous graft. Methods: A retrospective review was performed of all cases of infected prosthetic arteriovenous graft removal with bovine tissue arterial repair was performed. Thirteen cases were identified. Presentation, location of graft, and causative organism were reviewed; outcomes including reoperation and mortality were recorded. Results: Of the 13 patients, 12 (92%) had positive cultures of the graft, bloodstream, or wound. Methicillin-resistant Staphylococcus aureus was the most commonly isolated organism (54%). There were two unplanned reoperations including hematoma drainage and wound debridement within the first year. Over the 1-year follow-up period, 1 patient died for a mortality of 8%. There were no re-infections during follow-up. Discussion: Prosthetic arteriovenous graft infection remains a difficult challenge and is associated with significant morbidity and mortality. It presents in a variety of ways, including within an old thrombosed graft. Over the last several years, the causative organism has increasingly become drug resistant. Treatment with total graft excision requires arteriotomy closure, and for this bovine tissue has been demonstrated to be a viable option.

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

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

Retrograde thrombendarterectomy vs. ilio-femoral bypass in unilateral iliac TASC C and D lesions

VASA ◽  
2015 ◽  
Vol 44 (3) ◽  
pp. 0211-0219 ◽  
Author(s):  
Ingolf Töpel ◽  
Matthias Wiesner ◽  
Christian Uhl ◽  
Thomas Betz ◽  
Markus G. Steinbauer
Keyword(s):  
Graft Infection ◽  
External Iliac Artery ◽  
Prosthetic Graft ◽  
Long Term Results ◽  
Local Conditions ◽  
Prosthetic Graft Infection ◽  
Significant Difference ◽  
Short And Long Term

Background: To compare short and long term results of retrograde Thrombendarterectomy (rTEA) and ilio-femoral Bypass (IFBP) to treat iliac TASC C and D lesions. Patients and methods: Retrospective analysis of 108 patients treated at a single vascular center by either rTEA (n = 42) or IFBP (n = 66) over a period of 4 years. Results: Both methods did not significantly differ in 30-day (rTEA 0 % vs IFBP 2 %) or long-term mortality (rTEA 24 % vs IFBP 30 % at 4 years) with a median follow-up of 46 months. There were no procedure related deaths. Patency was similar for both groups (rTEA 93 % vs IFBP 98 % at 30 days; rTEA 83 % vs 92 % IFBP at 4 years). We could not find a significant difference in limb salvage rates (rTEA 93 % vs IFBP 100 % at 30 days and at 4 years). The incidence of prolonged lymphorrhea was significantly higher in the IFBP group (rTEA 0 % vs IFBP 21 %). In 4 IFBP patients a prosthetic graft infection occurred. Conclusions: Regarding short and long term results operative procedures as rTEA and IFBP still represent the gold standard in the treatment of TASC C and D lesions of the external iliac artery especially in patients with additional lesions in the common femoral and profundal femoral artery. Taking into account certain anatomical characteristics (heavily calcified lesions, narrow external iliac arteries or very tortuous iliac segments) and individual local conditions (prior vascular procedures involving the femoral bifurcation) the single incision retrograde approach to the EIA with rTEA may have advantages over IFBP, especially concerning postoperative complications like lymphorrhea and graft infection.

Enhanced Perigraft Angiogenesis Prevents Prosthetic Graft Infection

2008 ◽  
Vol 86 (4) ◽  
pp. 1278-1284 ◽  
Author(s):  
Shinichi Sato ◽  
Yoshio Nitta ◽  
Yoshikatsu Saiki ◽  
Shunsuke Kawamoto ◽  
Atsushi Iguchi ◽  
...  
Keyword(s):  
Graft Infection ◽  
Prosthetic Graft ◽  
Prosthetic Graft Infection

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 Endoluminal negative pressure wound treatment of anastomotic leakage in rectal surgery patients – critical review of the literature.

2015 ◽  
Vol 2 (1) ◽  
Author(s):  
Edward Huľo
Keyword(s):  
Anastomotic Leakage ◽  
Negative Pressure ◽  
Graft Infection ◽  
Rectal Surgery ◽  
Wound Dehiscence ◽  
Prosthetic Graft ◽  
Prosthetic Material ◽  
Review Of The Literature ◽  
Septic Complications ◽  
Prosthetic Graft Infection

During past 20 years the use of negative pressure wound therapy (NPWT) has shown it effectivity and efficiency in treatment of different indications. These indications include treatment of septic complications of open surgery (open abdomen, enteroatmospheric fistulas, wound dehiscence including sternotomy infections, staged abdominal wall repair, diabetic foot syndrome, and salvage of infected prosthetic material) or their prevention (prevention of complications in skin graft application and prevention of prosthetic graft infection). Such use consists of either external use directly in the wound, or intracorporal applications (intraabdominal NPWT, intrathoracal NPWT).  New approaches and ways of application are evolving. One of new therapeutic methods are endoluminal use in both upper and lower gastrointestinal tract.  Authors performed and present thorough review of the literature on use of endoluminal NPWT in anastomotic leakage in rectal surgery patients.  Authors conclude, that endo NPWT is becoming a new and effective therapeutic method in treatment of septic complications of patients after rectal surgery.

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