Vascular Graft Infection – A Single Centre Analysis

J 2015

Vascular Graft Infection – A Single Centre Analysis

KYSELA, Petr and Zdeněk ŠILHART

Basic information

Original name

Vascular Graft Infection – A Single Centre Analysis

Authors

KYSELA, Petr (203 Czech Republic, guarantor, belonging to the institution) and Zdeněk ŠILHART (203 Czech Republic)

Edition

Journal of Vascular Medicine & Surgery, Omics International, 2015, 2329-6925

Other information

Language

English

Type of outcome

Článek v odborném periodiku

Field of Study

30200 3.2 Clinical medicine

Country of publisher

United States of America

Confidentiality degree

není předmětem státního či obchodního tajemství

RIV identification code

RIV/00216224:14110/15:00085639

Organization unit

Faculty of Medicine

Keywords in English

Vascular graft; Infection; Prevention; Allograft; Surgery

Abstract

V originále

Though the frequency of vascular graft infections is very low, its consequences are too serious. The paper aims at the vascular graft infection causes analysis in a single centre. Results achievable by means of several approaches have been discussed and a possible way of lowering the vascular graft infection rate has been tested. Material and methods: A population of 2812 patients having implanted an artificial vascular graft in 2000-2010 were prospectively followed up. Upon the analysis of risk factors, the control group of 653 patients operated on during 2011-2013 were followed up. Results: Number of vascular graft infections was 28 (1,0%). Amputation rate was 19% (5 patients) and the overall mortality 14% (4 patients). Leading signs of the infection were local findings in 88%. All patients with the infection had two or more co-existing independent risk factors picked out by chi-square statistics. It was obesity, repeated interventions and emergency surgery (p<0,001). Gender (men), co-existing infection, diabetes and too long bypass were also significant (p<0,01). There was not MRSA infection at all. After adoption of risk factors reducing approach, there was not proven decreased infection occurrence in patients with implanted artificial grafts. However, during the control period, a higher share of autologous grafts and endovascular methods were used. Thus the overall infection rate was reduced from 0,43 to 0,31%. Conclusion: The graft infection is not a matter of resistant bacteria, but the infection in general. An accumulation of more than two independent risk factors according to local situation should be avoided. As the infection treatment is very demanding with uncertain results, patient’s wish should be taken into account as well. In all primaries, the use of the artificials ought to be minimized and endovascular procedures should be preferred, where appropriate. Emergency surgery should be avoided by in time indication to revascularization.

Citovat

KYSELA, Petr and Zdeněk ŠILHART. Vascular Graft Infection – A Single Centre Analysis. Journal of Vascular Medicine & Surgery. Omics International, 2015, vol. 2015, S1, p. 1-6. ISSN 2329-6925.

@article{1323205,
   author = {Kysela, Petr and Šilhart, Zdeněk},
   article_number = {S1},
   keywords = {Vascular graft; Infection; Prevention; Allograft; Surgery},
   language = {eng},
   issn = {2329-6925},
   journal = {Journal of Vascular Medicine & Surgery},
   title = {Vascular Graft Infection – A Single Centre Analysis},
   volume = {2015},
   year = {2015}
}

TY  - JOUR
ID  - 1323205
AU  - Kysela, Petr - Šilhart, Zdeněk
PY  - 2015
TI  - Vascular Graft Infection – A Single Centre Analysis
JF  - Journal of Vascular Medicine & Surgery
VL  - 2015
IS  - S1
SP  - 1-6
EP  - 1-6
PB  - Omics International
SN  - 23296925
KW  - Vascular graft
KW  - Infection
KW  - Prevention
KW  - Allograft
KW  - Surgery
N2  - Though the frequency of vascular graft infections is very low, its consequences are too serious. The paper aims at the vascular graft infection causes analysis in a single centre. Results achievable by means of several approaches have been discussed and a possible way of lowering the vascular graft infection rate has been tested. Material and methods: A population of 2812 patients having implanted an artificial vascular graft in 2000-2010 were prospectively followed up. Upon the analysis of risk factors, the control group of 653 patients operated on during 2011-2013 were followed up. Results: Number of vascular graft infections was 28 (1,0%). Amputation rate was 19% (5 patients) and the overall mortality 14% (4 patients). Leading signs of the infection were local findings in 88%. All patients with the infection had two or more co-existing independent risk factors picked out by chi-square statistics. It was obesity, repeated interventions and emergency surgery (p<0,001). Gender (men), co-existing infection, diabetes and too long bypass were also significant (p<0,01). There was not MRSA infection at all. After adoption of risk factors reducing approach, there was not proven decreased infection occurrence in patients with implanted artificial grafts. However, during the control period, a higher share of autologous grafts and endovascular methods were used. Thus the overall infection rate was reduced from 0,43 to 0,31%. Conclusion: The graft infection is not a matter of resistant bacteria, but the infection in general. An accumulation of more than two independent risk factors according to local situation should be avoided. As the infection treatment is very demanding with uncertain results, patient’s wish should be taken into account as well. In all primaries, the use of the artificials ought to be minimized and endovascular procedures should be preferred, where appropriate. Emergency surgery should be avoided by in time indication to revascularization.
ER  -

KYSELA, Petr and Zdeněk ŠILHART. Vascular Graft Infection – A Single Centre Analysis. \textit{Journal of Vascular Medicine \&{} Surgery}. Omics International, 2015, vol.~2015, S1, p.~1-6. ISSN~2329-6925.

Detailed Information on Publication Record