ISSN : 1301-5680
e-ISSN : 2149-8156
Turkish Journal of Thoracic and Cardiovascular Surgery     
Abdullah ERDOĞAN, Necdet ÖZ, İrfan ESER, Abid DEMİRCAN, Levent DERTSİZ, Alpay SARTER
Akdeniz Üniversitesi, Tıp Fakültesi, Göğüs Kalp Damar Cerrahisi Kliniği, ANTALYA
Aim: To analyze graft infections (GI), a serious complication of vascular surgery, regarding the type of the graft, site of the graft and the causal agent. Method: The graft infections of the patients with prosthetic vascular grafts, who were hospitalized at the Department of Thoracic and Cardiovascular Surgery, Medical Faculty of Akdeniz University between the years of 1990-1999, were analyzed retrospectively. Results: Prosthetic vascular grafting was performed in a total of 285 cases. Dacron graft was used in 134(47%) cases and PTFE graft in 151(53%) cases. Of these cases, in 22(7,7%) graft infection was determined. Mean age of the patients was 62,3 years (range 25-74). Of the patients, only one was female and the rest were male. Half of the infected grafts were Dacron, and the other half were PTFE. Five(22%) of those patients had diabetes mellitus. Grafting was performed because of aneurysm(3 patients), trauma(1 patient), Takayasu arteritis(1 patient) and atherosclerosis (18 patients). The localization of the infected grafts was as follows: aortobifemoral (12 grafts) (54,5%), aortofemoral (1 graft) (4%), iliofemoral (3 grafts) (13%), femoropopliteal (5 grafts)(22%) and aortocarotid (1 graft)(4%) regions. In all patients the infection was seen at late postoperative period (1 month-6 years). The site of the infection was inguinal region in 17(77%) patients, femoropopliteal region in 2(9%) patients, cervical region in one(4%) patient and retroperitoneal region in 2(8%) patients. The most frequent causal agent for the graft infection was staphylococcus aureus. Medical treatment was commenced in one patient. The infected graft was removed surgically in 21 patients, and an extraanatomic bypass was performed in4(18%) patients in the same operation. A second grafting was performed in 14(63,6%) patients at a later operation; an extremity amputation was carried out in 4(%18) patients and 3(13,6%) patients died from graft infection. Conclusion: In our series the most common site of graft infection was inguinal region and the most frequent causal agent was staphylococcus aureus. Infections were commonly seen at the late postoperative period. This suggests that hygienic measures are important to prevent the graft infections in these patients.
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