title: Treatment strategies for aortic and peripheral prosthetic graft infection.
abstract: OBJECTIVE
  The aim of this study was to investigate the outcomes correlated with our treatment strategy for prosthetic graft infection.
  
  
  METHODS
  Seventeen patients were treated for prosthetic graft infections between 1997 and 2009. Initially, total graft excision was applied in five cases, partial graft excision was applied in six cases and graft preservation with drainage and irrigation was applied in six cases. Among the graft-preserved cases, four patients were infected with methicillin-resistant Staphylococcus aureus (MRSA) and treated with gentian violet (GV).
  
  
  RESULTS
  The overall survival rate was 88% at 30 days and 82% at 1 year in this series. Of the excised cases, nine patients survived; however, two patients died. Among the cases in which MRSA-infected grafts were preserved, three patients survived; however, one patient died under a septicemic state. Infected graft preservation was applied at a high rate of 36%, and the mortality rate remained at 16%, without any signs of graft reinfection.
  
  
  CONCLUSIONS
  In the treatment of infected grafts, the patient's condition should be considered in order to select the appropriate treatment in each case. Graft preservation should be considered as an alternative treatment option, especially in high-risk patients, and GV can be effective for conservative treatment of prosthetic graft infections, including MRSA infections.
authors.affiliation: Division of Vascular and Endovascular Surgery, Department of Surgery, Tokyo Medical and Dental University, 1-5-45 Yushima, Bunkyo-ku, Tokyo, 113-8519, Japan, igari.srg1@tmd.ac.jp.
authors.forename: Kimihiro
authors.initials: K
authors.lastname: Igari
authors.forename: Toshifumi
authors.initials: T
authors.lastname: Kudo
authors.forename: Takahiro
authors.initials: T
authors.lastname: Toyofuku
authors.forename: Masatoshi
authors.initials: M
authors.lastname: Jibiki
authors.forename: Norihide
authors.initials: N
authors.lastname: Sugano
authors.forename: Yoshinori
authors.initials: Y
authors.lastname: Inoue
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001014:Aortic Aneurysm / Q000601:surgery*; D001157:Arterial Occlusive Diseases / Q000601:surgery*; D019917:Blood Vessel Prosthesis Implantation / Q000009:adverse effects; D004322:Drainage; D005260:Female; D005840:Gentian Violet / Q000627:therapeutic use; D006801:Humans; D008297:Male; D055624:Methicillin-Resistant Staphylococcus aureus; D008875:Middle Aged; D011475:Prosthesis Failure; D016459:Prosthesis-Related Infections / Q000382:microbiology / Q000628:therapy*; D012189:Retrospective Studies; D013203:Staphylococcal Infections; D007507:Therapeutic Irrigation; D016896:Treatment Outcome
chemical_list: D005840:Gentian Violet
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