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Vol 10, No 3-4 (2008)
Published online: 2009-05-06
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The usage of silver-impregnated prostheses in the treatment of vascular prosthesis infections

Tomasz Urbanek, Marcin Kucharzewski, Damian Ziaja, Wacław Kuczmik, Przemysław Nowakowski, Piotr Piesik, Arkadiusz Krupowies, Dariusz Stańczyk, Henryka Chmurzewska, Krzysztof Ziaja
Chirurgia Polska 2008;10(3-4):141-149.

open access

Vol 10, No 3-4 (2008)
Published online: 2009-05-06

Abstract

Background: Vascular prosthesis infection poses one of the most dangerous complications following vascular procedures. Despite the availability of a number of treatment methods, there is still a shortage of a perfect method of treatment concerning these kinds of infections. In this report, our own experience regarding the usage of silver-impregnated prostheses in revascularization procedures within an infected field are presented.
Material and methods: Between the years 2003 and 2007 37 patients were admitted presenting infection of a vascular prosthesis and were treated with surgical procedures in which the infected graft was removed and revascularization was performed with the in situ method, using a silver-impregnated prosthesis (InterGard Silver). The mean age of patients was 61 years and 2 months (47-90 years). On admission to hospital, a patent vascular prosthesis was present in 36 patients (97%). Infection concerned 28 cases in which a vascular prosthesis had been implanted previously in the aorto-ilio-femoral segment (including 13 patients with a bifurcated prosthesis). As well as this, there were 4 cases of extra-anatomic bypasses and 5 patients who presented a prosthesis from the femoro-popliteal segment.
Results: During the early postoperative period, 7 (19%) of the 37 patients died. No death occurred in patients that had undergone replacement of a vascular prosthesis in the femoro-popliteal segment. In 4 patients who had previously undergone an extra-anatomic by-pass grafting, 2 patients died, while among 8 cases who had undergone a partial replacement of an aorto-femoral prosthesis 1 death was noted. The other 4 deaths (20%) concerned a group of patients that underwent an anatomic reconstruction in the aorto-ilio-femoral segment. During the early and late observation periods, reinfection occurred in 11 of the 37 patients who underwent surgery (29%), while 3 of these cases resulted in death.
Conclusions: The usage of silver-impregnated prostheses opens a window of opportunity for revascularization in cases of infection of previously implanted vascular prostheses, but does not guarantee a 100% complete recovery. There is still a lack of a perfect treatment method in patients with vascular prosthesis infection while the result of treatment is significantly dependent on both the presence of concomitant diseases and the patient’s preoperative general condition.

Abstract

Background: Vascular prosthesis infection poses one of the most dangerous complications following vascular procedures. Despite the availability of a number of treatment methods, there is still a shortage of a perfect method of treatment concerning these kinds of infections. In this report, our own experience regarding the usage of silver-impregnated prostheses in revascularization procedures within an infected field are presented.
Material and methods: Between the years 2003 and 2007 37 patients were admitted presenting infection of a vascular prosthesis and were treated with surgical procedures in which the infected graft was removed and revascularization was performed with the in situ method, using a silver-impregnated prosthesis (InterGard Silver). The mean age of patients was 61 years and 2 months (47-90 years). On admission to hospital, a patent vascular prosthesis was present in 36 patients (97%). Infection concerned 28 cases in which a vascular prosthesis had been implanted previously in the aorto-ilio-femoral segment (including 13 patients with a bifurcated prosthesis). As well as this, there were 4 cases of extra-anatomic bypasses and 5 patients who presented a prosthesis from the femoro-popliteal segment.
Results: During the early postoperative period, 7 (19%) of the 37 patients died. No death occurred in patients that had undergone replacement of a vascular prosthesis in the femoro-popliteal segment. In 4 patients who had previously undergone an extra-anatomic by-pass grafting, 2 patients died, while among 8 cases who had undergone a partial replacement of an aorto-femoral prosthesis 1 death was noted. The other 4 deaths (20%) concerned a group of patients that underwent an anatomic reconstruction in the aorto-ilio-femoral segment. During the early and late observation periods, reinfection occurred in 11 of the 37 patients who underwent surgery (29%), while 3 of these cases resulted in death.
Conclusions: The usage of silver-impregnated prostheses opens a window of opportunity for revascularization in cases of infection of previously implanted vascular prostheses, but does not guarantee a 100% complete recovery. There is still a lack of a perfect treatment method in patients with vascular prosthesis infection while the result of treatment is significantly dependent on both the presence of concomitant diseases and the patient’s preoperative general condition.
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Keywords

vascular surgery; infection; complications; silver-impregnated prosthesis

About this article
Title

The usage of silver-impregnated prostheses in the treatment of vascular prosthesis infections

Journal

Chirurgia Polska (Polish Surgery)

Issue

Vol 10, No 3-4 (2008)

Pages

141-149

Published online

2009-05-06

Bibliographic record

Chirurgia Polska 2008;10(3-4):141-149.

Keywords

vascular surgery
infection
complications
silver-impregnated prosthesis

Authors

Tomasz Urbanek
Marcin Kucharzewski
Damian Ziaja
Wacław Kuczmik
Przemysław Nowakowski
Piotr Piesik
Arkadiusz Krupowies
Dariusz Stańczyk
Henryka Chmurzewska
Krzysztof Ziaja

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