Conservative treatment of prosthetic graft infection with vacuum assisted closure therapy and selective double antibiotic therapy

Abstract

t T Prosthetic graft infection is one of the most feared complications in arterial revascularization surgery. Its management is challenging, may compromise durability of reconstructions, limb viability and can pose a lifethreatening condition. Established concepts for successful management of prosthetic graft infection required total prosthetic resection, extensive tissue debridement and extra-anatomic bypass to ensure limb perfusion. Vacuum assisted closure therapy (VAC-therapy) as adjunctive treatment for groin infections following vascular procedures, has been associated with successful treatment without graft explantation, in some published series. However, in the presence of very aggressive microorganisms may not be sufficient for a successful treatment. Staphylococcus species are the most prevalent pathogens causing vascular prosthesis infection; the introduction of more selective