Skip to main content
Log in

Skin sliding closure technique is effective for management of infected prostheses in cases of arterial reconstruction with synthetic grafts

  • Original Articles
  • Published:
The Japanese journal of surgery Aims and scope Submit manuscript

Abstract

A clinical review of 400 prosthetic arterial reconstructions, carried out in the Second Department of Surgery of Kyushu University Hospital during a period from 1965 to 1981, revealed 10 graft infections (2.5 per cent). There were two out of 120 abdominal aneurysms (1.7 per cent) and 8 out of 260 aorto-femoral occlusive diseases (3.1 per cent). The contributing factors included intraoperative contamination with duodenal juice during surgery for abdominal aneurysms ruptured into the duodenum (2 cases), minor hematoma and/or lymphorrhoea at the groin or lower abdominal wall (5 cases), wound infection (1 case), compression necrosis of the sigmoid colon by the implanted graft (1 case) or perityphlitic abscess due to a perforating appendicitis (1 case). Bacteriologic examination revealed a predominance of a variety of staphylococcus at the groin or lower abdominal wall and E. coli in the abdominal cavity. Four patients expired. Limb amputation had to be done in 2, and 4 were cured. In the management of infected graft at the groin or lower abdominal wall, we used with success a skin sliding closure technique after continuous wound lavage in 3 patients.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Similar content being viewed by others

References

  1. Szilagyi, D.E., Smith, R.F., Elliott, J.P. and Vrandecic, M.P.: Infection in arterial reconstruction with synthetic grafts. Ann. Surg. 176: 321–333, 1972.

    PubMed  CAS  Google Scholar 

  2. Goldstone, J. and Moore, W.: Infection in vascular prostheses. Am. J. Surg. 128: 225–233, 1974.

    Article  PubMed  CAS  Google Scholar 

  3. Moriyama, M., Oka, N., Kusaba, A., Kiyose, T. and Inokuchi, K.: Abdominal aneurysm with aortoduodenal fistula. Jpn. J. Surg. 6: 29–34, 1976.

    Article  PubMed  CAS  Google Scholar 

  4. Fry, W.J. and Lindenauer, S.M.: Infection complicating the use of plastic arterial implants. Arch. Surg. 94: 600–609, 1967.

    PubMed  CAS  Google Scholar 

  5. Conn, J.H., Hardy, J.D., Chavez, C.M. and Fain, W.R.: Infected arterial grafts: Experience in 22 cases with emphasis on unusual bacteria and techniques. Ann. Surg. 171: 704–714, 1970.

    PubMed  CAS  Google Scholar 

  6. Hoffert, P.W., Gensler, S. and Haimovici, H.: Infection complicating arterial grafts. Arch. Surg. 90: 427–435, 1965.

    PubMed  CAS  Google Scholar 

  7. Kripski, W.C., Mitchell, R.A., Gewertz, B.L. and Fry, W.J.: Appendicitis and aortofemoral graft infection. Arch. Surg. 114: 969, 1979.

    Google Scholar 

  8. Schramel, R.J. and Creech, O.: Effects of infection and exposure on synthetic arterial prostheses. Arch. Surg. 78: 271–279, 1959.

    CAS  Google Scholar 

  9. Scobie, K., McPhail, N. and Barber, G.: Bacteriologic monitoring in abdominal aortic surgery. Canad. J. Surg. 22: 368–371, 1979.

    PubMed  CAS  Google Scholar 

  10. Shaw, R.S. and Baue, A.E.: Management of sepsis complicating arterial reconstruction surgery. Surgery 53: 75–86, 1963.

    PubMed  CAS  Google Scholar 

  11. Blaisdell, F.W., Hall, A.D., Lim, R.C. and Moore, W.S.: Aorto-iliac arterial substitution utilizing subcutaneous grafts. Ann. Surg. 172: 775–780 1970.

    PubMed  CAS  Google Scholar 

  12. Ehrenfeld, W.K., Wilbur, B.G., Olcott, C.N. and Stoney, R.J.: Autogenous tissue reconstruction in the management of infected prosthetic grafts. Surgery 85: 82–92, 1979.

    PubMed  CAS  Google Scholar 

  13. Yashar, J.J., Weyman, A.D., Burnard, R.J. and Yashar, J.: Survival and limb salvage in patients with infected arterial prostheses. Am. J. Surg. 135: 499–503, 1978.

    Article  PubMed  CAS  Google Scholar 

  14. Busuttil, R.W., Gewirtz, H. and Baker, J.D.: Salvage of infected axillofemoral bypass graft with a local bipedicle flap. Vascular Surgery 13: 151–156, 1979.

    Google Scholar 

  15. Carter, S.C., Cohen, C.A. and Whelan, T.J.: Clinical experience with management of the infected dacron graft. Ann. Surg. 158: 249–255, 1963.

    Google Scholar 

  16. Ehrenfeld, W.K.: Complications in vascular surgery, pp. 503–516 Bernhard, V.M. and Towne, J.B. eds., Grune & Stratton, New York, 1980.

    Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Rights and permissions

Reprints and permissions

About this article

Cite this article

Okadome, K., Watanabe, T., Kina, M. et al. Skin sliding closure technique is effective for management of infected prostheses in cases of arterial reconstruction with synthetic grafts. The Japanese Journal of Surgery 12, 349–355 (1982). https://doi.org/10.1007/BF02469634

Download citation

  • Received:

  • Issue Date:

  • DOI: https://doi.org/10.1007/BF02469634

Key Words

Navigation