This journal is
indexed in Scopus
Year 2019 Vol. 27 No 3
T. VYKHTYUK, V. ZHYKOVSKIY
SURGICAL SITE INFECTION IN PATIENTS WITH THE DESTRUCTION OF THE VASCULAR IMPLANT
Danylo Halytsky Lviv National Medical University, Lviv,
Treatment of patients with occlusive-stenotic lesions of the lower limb arteries in the stage of critical limb ischemia and postoperative infectious complications is a pressing issue of modern vascular surgery. If a patient has a vascular prosthesis, the development of a surgical site infection can lead to arrosive bleeding with fatal outcome. The aim of this report is to demonstrate the case of successful surgical treatment of a patient with an infected synthetic vascular implant. The patient, born in 1962, addressed to a vascular surgeon 2 months after the surgical treatment of critical ischemia of the right lower limb with implantation of linear femoropopliteal prosthesis. The patient complained of the development of a wound with discharge and unpleasant odor. After inspection and examination of the patient, the infection of the vascular prosthesis with the formation of the fistula on the medial surface of the lower third of the right thigh was diagnosed. Surgical intervention was performed: removal of the infected femoropopliteal prosthesis with simultaneous autovenous femoropopliteal repeated bypass surgery by the great saphenous vein, performed subcutaneously, extra-anatomically within the healthy soft tissues, bypassing the infected area of the lower third of the thigh. Thus, one was able to save the limb of the patient, to prevent the development of arrosive bleeding and to improve the healing and recovery of the suppurative thigh lesion.
- Madden NJ, Calligaro KD, Dougherty MJ, Zheng H, Troutman DA. Lateral femoral bypass for prosthetic arterial graft infections in the groin. J Vasc Surg. 2019 Apr;69(4):1129-36. doi: 10.1016/j.jvs.2018.07.041
- Inui T, Bandyk DF. Vascular surgical site infection: risk factors and preventive measures. Semin Vasc Surg. 2015 Sep-Dec;28(3-4):201-7. doi: 10.1053/j.semvascsurg.2016.02.002
- Miyahara T, Hoshina K, Ozaki M, Ogiwara M. Efficacy of preoperative antibiotic therapy for the treatment of vascular graft infection. Ann Vasc Dis. 2018 Jun 25;11(2):191-95. doi: 10.3400/avd.oa.17-00128
- Miyake K, Sakagoshi N, Kitabayashi K. Results of graft removal and negative pressure wound therapy in management of graft infection. Int J Angiol. 2019 Mar;28(1):39-43. doi: 10.1055/s-0038-1676798
- Rancic Z, Ledergerber B, Veith FJ, Anagnostopoulos A, Lachat ML, Hasse B. Good early results of negative pressure wound nonexcisional treatment for prosthetic graft infection are durable. J Vasc Surg. 2018 Jun;67(Is 6):e62. doi: 10.1016/j.jvs.2018.03.039
- Legout L, Delia P, Sarraz-Bournet B, Rouyer C, Massongo M, Valette M, Leroy O, Haulon S, Senneville E. Factors predictive of treatment failure in staphylococcal prosthetic vascular graft infections: a prospective observational cohort study: impact of rifampin. BMC Infect Dis. 2014 Apr 28;14:228. doi: 10.1186/1471-2334-14-228
- Ketenciler S, Boyacioğlu K, Akdemir I, Kömürcü G, Polat A. Autologous saphenous vein panel graft for vascular reconstruction. Ann Vasc Surg. 2018 Nov;53:117-22. doi: 10.1016/j.avsg.2018.05.037
Lviv, Pekarskaya Str., 69,
Danylo Halytsky Lviv National
Surgery Department №2.
Tel. +38 032 275-76-32,
Taras I. Vykhtyuk
Vykhtyuk Taras I., Assistant of Surgery Department №2, Danylo Halytsky Lviv National Medical University, Lviv, Ukraine.
Zhykovskiy Volodymyr S., PhD, Assistant of the Department of Disaster Medicine and Military Medicine, Danylo Halytsky Lviv National Medical University, Lviv, Ukraine.