title: Fate of infected and eroded hemodialysis grafts and autogenous fistulas.
abstract: Between 1970 and 1991, we placed 1,090 grafts (bovine and polytetrafluoroethylene) in 1,041 patients and created 1,034 autogenous fistulas in 856 patients for hemodialysis. Subsequent revisions for complications resulted in a total of 3,944 operations performed in patients with grafts and 1,633 operations in patients with autogenous fistulas. A total of 255 infections developed in 158 of the patients with grafts, whereas 8 infections developed in 7 patients with autogenous fistulas. The puncture infection rate was 5%/yr (12%/yr for a second puncture infection). The clean wound infection rate was 3% for grafts and 0.4% for autogenous fistulas. We made an attempt to salvage the graft, usually with a segmental bypass, in 75% of patients with a graft infection. Grafts were salvaged in 80% of patients in whom salvage was attempted (60% of all patients with an infection). The results in the few patients with infected autogenous fistulas were relatively poor.
authors: Department of Surgery, Swedish Hospital Medical Center, Seattle, Washington.
authors: B
authors: B
authors: Taylor
authors: R D
authors: RD
authors: Sigley
authors: K J
authors: KJ
authors: May
mesh_terms: D000328:Adult; D001166:Arteriovenous Shunt, Surgical / Q000009:adverse effects; D001807:Blood Vessel Prosthesis / Q000009:adverse effects; D002408:Catheters, Indwelling / Q000009:adverse effects*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D006435:Renal Dialysis / Q000009:adverse effects*; D012086:Reoperation; D013203:Staphylococcal Infections / Q000209:etiology / Q000601:surgery*; D013530:Surgical Wound Infection / Q000209:etiology / Q000601:surgery*; D014656:Vascular Surgical Procedures