title: Evolving microbiology and treatment of extracavitary prosthetic graft infections.
abstract: The authors report the microbiology and outcomes following an individualized treatment algorithm for extracavitary (EC) prosthetic graft infection, including the use of graft preservation and in situ graft replacement techniques. A retrospective 8-year review of 87 patients treated for EC prosthetic graft infections was carried out. The treatment algorithm included culture-specific antibiotic therapy, surgical site debridement with antibiotic bead placement, selected graft preservation with muscle flap coverage, or graft excision with in situ conduit replacement. Outcomes measured included death, limb loss, and recurrent infection. It was found that present-day management of EC prosthetic graft infections is associated with lower mortality and morbidity despite changes in microbiology and the increased application of graft preservation and in situ grafting treatments.
authors.affiliation: Department of Vascular Surgery, West Virginia University, Charleston 25311 USA. pstone0627@yahoo.com
authors.forename: Patrick A
authors.initials: PA
authors.lastname: Stone
authors.forename: Martin R
authors.initials: MR
authors.lastname: Back
authors.forename: Paul A
authors.initials: PA
authors.lastname: Armstrong
authors.forename: Robert S
authors.initials: RS
authors.lastname: Brumberg
authors.forename: Sarah K
authors.initials: SK
authors.lastname: Flaherty
authors.forename: Brad L
authors.initials: BL
authors.lastname: Johnson
authors.forename: Murray L
authors.initials: ML
authors.lastname: Shames
authors.forename: Dennis F
authors.initials: DF
authors.lastname: Bandyk
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000465:Algorithms; D000671:Amputation, Surgical; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D001807:Blood Vessel Prosthesis / Q000009:adverse effects*; D019917:Blood Vessel Prosthesis Implantation / Q000009:adverse effects* / Q000295:instrumentation; D003131:Combined Modality Therapy; D003646:Debridement; D020878:Device Removal; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D016459:Prosthesis-Related Infections / Q000382:microbiology* / Q000401:mortality / Q000628:therapy*; D012008:Recurrence; D012086:Reoperation; D012189:Retrospective Studies; D013524:Surgical Flaps; D013997:Time Factors; D016896:Treatment Outcome
chemical_list: D000900:Anti-Bacterial Agents