Prosthetic infections.

ABSTRACT

BACKGROUND: The authors report the up to date trends regarding the etiopathology, diagnosis and treatment of vascular-graft infections. This paper concerns the responsible micro-organisms; the reference to the formation of anastomotic pseudo-aneurysm for the infections involving the lines of suture and the reference to the aortoenteric fistula. METHODS: A case study which refers to the period between 1990 and 1999 presents 19 cases of prosthetic infections out of 520 operations of implants of prosthetic materials. RESULTS: 11 successful, 7 amputations, 1 decrease. CONCLUSIONS: In the past years the results of the treatment have improved thanks to a more refined and codified therapeutical conduct and to the employment of prosthetic materials which are more resistant to infection, or to a greater attention paid to asepsis, before, during and after surgery to antibiotic prophylaxis before, during and after the operation. But, nevertheless graft infection still remains a dreadful complication for vascular surgery operations. The therapeutical approach is substantially aggressive and the removal of the infected prosthesis is essential. Nevertheless we believe that we should not underestimate open local treatment, which in localized and superficial infections and infections not involving anastomosis allows us to preserve prosthesis and make it root.