Intraoperative bacterial contamination of vascular grafts: a prospective study.
The establishment of graft infection depends on host response, an appropriate field and bacterial contamination. Intraoperative bacterial contamination of prosthetic graft material was studied prospectively in 77 patients. Vascular reconstruction was indicated for abdominal aortic aneurysm (15%), claudication (42%), rest pain (25%) and ulceration or gangrene (18%). In 78% of cases the procedure was elective. Staphylococcus epidermidis was isolated in 80% of cultures; mixed flora were more frequent in patients with rest pain (60%) and ulceration or gangrene (45%) than in those with aneurysms (22%) or claudication (16%). Grafts became contaminated in 56% of cases using standard techniques; this was lowered to 35% when the surgeon changed gloves before preclotting the graft. There was no significant difference with respect to the surgeon who performed the operation, the indication for operation, primary versus secondary repair or the use of skin barriers. One patient (1.3%) had an established graft infection. It is concluded that the incidence of contamination is high but may be decreased by glove changing.
D000368:Aged; D001424:Bacterial Infections / Q000209:etiology* / Q000517:prevention & control; D001807:Blood Vessel Prosthesis / Q000009:adverse effects; D005260:Female; D005932:Gloves, Surgical; D006801:Humans; D007431:Intraoperative Complications / Q000382:microbiology; D008297:Male; D008875:Middle Aged; D013530:Surgical Wound Infection / Q000209:etiology / Q000517:prevention & control*; D014656:Vascular Surgical Procedures / Q000009:adverse effects*