title: [Silver-coated dacron prosthesis in the treatment of infection in arterial surgery: case reports].
abstract: BACKGROUND
  Although the incidence is low, infection of prosthetic vascular graft bears a high incidence of serious complications including 25-75% mortality rate and 40-75% limb loss. The standard treatment of vascular graft infection consists of excision of the prosthesis, wound debridement and extraanatomic revascularization. Conservative treatment might be an option in a limited number of patients. We present three cases of surgical and conservative treatment of vascular graft infection.
  
  
  METHODS
  Case 1: A patient developed silver-coated graft infection after femorodistal arterial reconstruction performed because of critical limb ischemia. In the early postoperative period, massive skin and subcutaneous tissue necrosis developed, with the graft being exposed. After two months of persistent debridement and wound toilette, the defect was covered with aThiersch skin graft. Case 2: PTFE graft infection in the right groin followed reconstruction of the isolated common femoral artery aneurysm. This graft was replaced with a silver-coated graft in situ. Reinfection of the proximal end of the implanted silver-coated graft occurred and the graft was exposed. After repeated debridement and wound toilette, the exposed prosthesis was covered with granulomatous tissue, and the wound healed. Case 3: A year after anastomotic pseudoaneurysm resection in the left groin, prosthesis was exposed following wound infection. This graft was substituted with a silver-coated graft in situ. The wound healed primarily.
  
  
  CONCLUSIONS
  These three cases demonstrate that under some circumstances vascular prosthesis infection can be successfully treated conservatively without graft removal, and also by in situ replacement using silver-coated graft.
authors.forename: Dragoslav
authors.initials: D
authors.lastname: Nenezić
authors.forename: Predrag
authors.initials: P
authors.lastname: Matić
authors.forename: Predrag
authors.initials: P
authors.lastname: Gajin
authors.forename: Nenad
authors.initials: N
authors.lastname: Iijevski
authors.forename: Dario
authors.initials: D
authors.lastname: Jocić
authors.forename: Petar
authors.initials: P
authors.lastname: Popov
authors.forename: Miroslav
authors.initials: M
authors.lastname: Milicić
authors.forename: Djordje
authors.initials: D
authors.lastname: Radak
mesh_terms: D000368:Aged; D001807:Blood Vessel Prosthesis / Q000009:adverse effects; D020878:Device Removal; D005260:Female; D006119:Groin / Q000098:blood supply; D006801:Humans; D007866:Leg / Q000098:blood supply*; D008297:Male; D008875:Middle Aged; D011093:Polyethylene Terephthalates; D016459:Prosthesis-Related Infections / Q000601:surgery*; D012834:Silver
chemical_list: D011093:Polyethylene Terephthalates; D012834:Silver