[Prevention of bacterial grafts on revascularization of the arteries of the leg. Apropos of 18 infections in 1000 surgically treated cases].
The incidence of vascular and prosthetic infections was compared during two successive periods, each involving approximately 500 surgical acts, a strict protocol of infection prophylaxis being applied during the second period: infection was reduced from 2.7 to 1.5 p. cent (2.3 to 0.5 p. cent after aorto-ilio-femoral grafts). Failure to respond to treatment during the second period occurred under two circumstances: when prophylaxis was insufficient to cover emergency procedures, and when antibiotic therapy was directed against staphylococci only, resulting in persistence of a high level of infections due to Gram-negative bacilli. Analysis of different epidemiological factors, including the germs, the patient, the treating team, and the prosthesis, led to the adoption of numerous specific measures. Their respect implies collective awareness, assisted by analysis of weekly complications and annual results with the involvement of the total team. Prophylactic antibiotic therapy should be of short duration, the antibiotics being selected in reference to the sensitivity of the germs included in the hospital statistics, and of the antibiotic policy which reserves recently developed molecules for curative purposes.
D000368:Aged; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D001012:Aorta, Abdominal / Q000601:surgery; D001424:Bacterial Infections / Q000209:etiology / Q000517:prevention & control*; D001807:Blood Vessel Prosthesis / Q000009:adverse effects*; D004756:Enterobacteriaceae Infections / Q000517:prevention & control; D005260:Female; D005263:Femoral Artery / Q000601:surgery; D006801:Humans; D007083:Iliac Artery / Q000601:surgery; D007866:Leg / Q000098:blood supply*; D008297:Male; D008875:Middle Aged; D012086:Reoperation; D013203:Staphylococcal Infections / Q000517:prevention & control; D014652:Vascular Diseases / Q000209:etiology / Q000517:prevention & control*
D000900:Anti-Bacterial Agents
Prévention des greffes bactériennes sur revascularisation des artères des membres inférieurs. A propos de 18 infections chez 1000 opérés.