title: Surgical treatment of methicillin-resistant Staphylococcus aureus infection following infrainguinal arterial reconstruction.
abstract: A 64-year-old man was referred to our hospital with Methicillin-resistant Staphylococcus aureus (MRSA) infection following infrainguinal arterial reconstruction. As repeated MRSA sepsis occurred, we decided to remove the infected graft with distal revascularization via circuitous graft tunneling to avoid serious infections and allow limb salvage. An iliofemoro bypass was performed via an extra-anatomical bypass, from just below the iliac crest into the musculus quadriceps femoris using an 8 mm-ringed polyester gelatin polypropylene tube graft, with complete debridement of a groin infection. Postoperative 3-dimentional CT angiography revealed that the prostheses was patent and the patient had an uneventful postoperative course. We concluded that this extra-anatomical bypass was a safe procedure and an excellent option for patients with an infected vascular prosthetic graft in the groin after previous revascularization, like in our case with no available autogeneous vein grafts.
authors.affiliation: Department of Thoracic and Cardiovascular Surgery, Hiroshima Prefectural Hospital, Hiroshima, Japan.
authors.forename: Shinji
authors.initials: S
authors.lastname: Hirai
authors.forename: Yoshiharu
authors.initials: Y
authors.lastname: Hamanaka
authors.forename: Norimasa
authors.initials: N
authors.lastname: Mitsui
authors.forename: Masahiko
authors.initials: M
authors.lastname: Morifuji
authors.forename: Miwa
authors.initials: M
authors.lastname: Sutoh
mesh_terms: D000792:Angiography; D001807:Blood Vessel Prosthesis / Q000009:adverse effects*; D003646:Debridement; D006801:Humans; D008297:Male; D016106:Methicillin Resistance; D008875:Middle Aged; D016459:Prosthesis-Related Infections / Q000601:surgery*; D012086:Reoperation; D013203:Staphylococcal Infections / Q000601:surgery*; D013211:Staphylococcus aureus / Q000187:drug effects; D014654:Vascular Patency; D014656:Vascular Surgical Procedures