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Evolving Microbiology and Treatment of Extracavitary Prosthetic Graft Infections

Department of Vascular Surgery, West Virginia University, Charleston, pstone0627{at}yahoo.com

Martin R. Back, MD

Department of Vascular Surgery, the University of South Florida, Tampa, Florida

Paul A. Armstrong, MD

Department of Vascular Surgery, the University of South Florida, Tampa, Florida

Robert S. Brumberg, MD

Department of Vascular Surgery, the University of South Florida, Tampa, Florida

Sarah K. Flaherty, MD

Marshall University School of Medicine, Huntington, West Virginia

Brad L. Johnson, MD

Department of Vascular Surgery, the University of South Florida, Tampa, Florida

Murray L. Shames, MD

Department of Vascular Surgery, the University of South Florida, Tampa, Florida

Dennis F. Bandyk, MD

Department of Vascular Surgery, the University of South Florida, Tampa, Florida

The authors report the microbiology and outcomes following an individualized treatment algorithm for extracavitary (EC) prosthetic graft infection, including the use of graft preservation and in situ graft replacement techniques. A retrospective 8-year review of 87 patients treated for EC prosthetic graft infections was carried out. The treatment algorithm included culture-specific antibiotic therapy, surgical site debridement with antibiotic bead placement, selected graft preservation with muscle flap coverage, or graft excision with in situ conduit replacement. Outcomes measured included death, limb loss, and recurrent infection. It was found that present-day management of EC prosthetic graft infections is associated with lower mortality and morbidity despite changes in microbiology and the increased application of graft preservation and in situ grafting treatments.

Key Words: infection • extracavitary

This version was published on January 1, 2009

Vascular and Endovascular Surgery, Vol. 42, No. 6, 537-544 (2009)
DOI: 10.1177/1538574408322658


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