Simultaneous extra-anatomic bypass and abdominal "flag flap" for lower limb salvage in a patient with severe post-bypass anastomotic groin infection.
The incidence of prosthetic graft infection after bypass surgery ranges from 0.2 to 5%, depending on location, co-morbid diseases and host defense mechanisms. In spite of surgical treatment, the amputation rate can be up to 67%. Herein, we present our treatment strategy for a patient with severe Methicillin Resistant Staphylococcus Aureus infection and pseudo-aneurysm after a femoropopliteal bypass with a prosthetic graft. An extra-anatomic bypass without touching the previously operated groin area (aseptic time) was done at the beginning. Radical debridement (septic time) and simultaneous abdominal "flag flap" were performed in the same surgical procedure to save the lower limb.
Fodor
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M
Department of Vascular Surgery, First Surgical Clinic, Emergency District Hospital, Cluj-Napoca, Romania. drfodor@yahoo.com
Fodor
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L
Ciuce
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D000368:Aged; D000714:Anastomosis, Surgical; D001807:Blood Vessel Prosthesis / Q000009:adverse effects*; D019917:Blood Vessel Prosthesis Implantation; D003646:Debridement; D005260:Female; D006801:Humans; D007511:Ischemia / Q000601:surgery*; D007866:Leg / Q000098:blood supply*; D023821:Limb Salvage; D055624:Methicillin-Resistant Staphylococcus aureus; D016459:Prosthesis-Related Infections / Q000601:surgery*; D013203:Staphylococcal Infections / Q000601:surgery*; D013524:Surgical Flaps