Slovenská chirurgia 1/2015

Infection of prosthesis after vascular reconstructive procedures

The incidence of prosthetic graft infections vary from 1 percent to 6 percent Successful management can be attributed to the development of better staging systems, operative delineation of the extent of infection, and a better appreciation of the potential virulence of the microbes involved (5, 6, 8). We have used classification system of extracavitary vascular graft infections established by Szillagyi (1, 2). Incidence of vascular infections is influenced by patient’s general condition, the type of theprocedure, the coexistence of other simultaneous inflammation sites, the type of prophylactic antibiotics given perioperatively and by prolonged operative time and hospitalstay (8, 9). Infections are much more frequent in the groins (60 % of cases), in grafts placed in a subcutaneous tunnel and after emergency cases (e. g. acute arterial ischemia). Infection can also develop after percutaneous stent angioplasty but in low rates (0,5 %) (4, 5, 7). Authors report our own experiences with the case of a 58 year-old patient who had undergone a Fogarthy embolectomy with critical ischemia of the rigt lower extremity. Vascular graft procedure was created at our service April 17, 2013 bypass AIE – AFS l dx. cum prosthesis lienaris PTFE 8 mm reimplantatio AFP ad bypass AFP, AFS, AP l. dx. Trombectomia et desobliteratio AFP, AFS, AP l. dx. cum Fogarthy catheter No 3,4 et ring stripper, Trombectomia ATA et tractus, tibiofibularis l. dx. directa et cum Fogarthy catheter, repeated infection of vascular prosthesis lead to serious sepsis with multiorgan dysfunction and high amputation of right limbs at the femoral level.

Keywords: ischemia of the limbs, revascularisation, infection of the vascular prosthesis, sepsis, etiologia, case report.